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        <OfficerInd>X</OfficerInd>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RAFAEL RODRIGUEZ</PersonNm>
        <TitleTxt>CHAIR-ELECT</TitleTxt>
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        <OfficerInd>X</OfficerInd>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DIANA LOZANO</PersonNm>
        <TitleTxt>BOARD MEMBER END 12/22</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JEAN SWINNEY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MARIA PAGAN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL MORIARTY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>RUBEN SANTIAGO</PersonNm>
        <TitleTxt>BOARD MEMBER BEG 12/22</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TRACY MACGRATH</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <TotalReportableCompFromOrgAmt>2454599</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>130110</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>67</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>COMMUNITY TECHNOLOGY COOPERATIVE</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>75 FEDERAK STREET 7TH FLOOR</AddressLine1Txt>
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            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02110</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EHR CONVERSION</ServicesDesc>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>BAYSTATE MEDICAL CENTER</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>759 CHESTNUT STREET</AddressLine1Txt>
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          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL SERVICES</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>VITALITY TECHNOLOGIES</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>442 WESTFIELD STREET</AddressLine1Txt>
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            <StateAbbreviationCd>MA</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DENTAL LABORATORY</ServicesDesc>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>KLEEBURG MECHANICAL</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>65 WESTOVER ROAD</AddressLine1Txt>
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            <StateAbbreviationCd>MA</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HVAC SERVICE</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>NEW ENGLAND COLLEGE OF OPTOMETRY</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>424 BEACON STREET</AddressLine1Txt>
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          </USAddress>
        </ContractorAddress>
        <ServicesDesc>OPTOMETRY SERVICES</ServicesDesc>
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      <GovernmentGrantsAmt>9680231</GovernmentGrantsAmt>
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      <TotalContributionsAmt>10312745</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>20159920</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>20159920</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PHARMACY REVENUE</Desc>
        <BusinessCd>456110</BusinessCd>
        <TotalRevenueColumnAmt>28791366</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>28791366</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>DSRIP REVENUE</Desc>
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        <RelatedOrExemptFuncIncomeAmt>858734</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>COST POOL SAVINGS</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>519644</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>519644</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>510852</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>510852</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>50840516</TotalProgramServiceRevenueAmt>
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        <ExclusionAmt>143492</ExclusionAmt>
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      <RoyaltiesRevenueGrp>
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      <RentalIncomeOrLossGrp>
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      <NetRentalIncomeOrLossGrp>
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        <ExclusionAmt>143437</ExclusionAmt>
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      <NetGainOrLossInvestmentsGrp>
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      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
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      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
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      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
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      <TotalRevenueGrp>
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        <ExclusionAmt>286929</ExclusionAmt>
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      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>493325</ProgramServicesAmt>
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      <GrantsToDomesticIndividualsGrp>
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      <ForeignGrantsGrp>
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      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
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        <ProgramServicesAmt>443701</ProgramServicesAmt>
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        <ProgramServicesAmt>17318506</ProgramServicesAmt>
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        <ProgramServicesAmt>1650957</ProgramServicesAmt>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>22611</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>163818</ManagementAndGeneralAmt>
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      <FeesForServicesLobbyingGrp>
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      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
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      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
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        <ProgramServicesAmt>6664</ProgramServicesAmt>
        <ManagementAndGeneralAmt>389855</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>88204</ProgramServicesAmt>
        <ManagementAndGeneralAmt>109904</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>361409</ProgramServicesAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>46529</ProgramServicesAmt>
        <ManagementAndGeneralAmt>57976</ManagementAndGeneralAmt>
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      <PymtTravelEntrtnmntPubOfclGrp>
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      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>77861</ProgramServicesAmt>
        <ManagementAndGeneralAmt>97018</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>180170</ProgramServicesAmt>
        <ManagementAndGeneralAmt>79593</ManagementAndGeneralAmt>
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      <PaymentsToAffiliatesGrp>
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        <ProgramServicesAmt>737883</ProgramServicesAmt>
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        <ProgramServicesAmt>68913</ProgramServicesAmt>
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        <ProgramServicesAmt>19186301</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>663471</ProgramServicesAmt>
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      <OtherExpensesGrp>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>69777</ProgramServicesAmt>
        <ManagementAndGeneralAmt>86945</ManagementAndGeneralAmt>
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        <EOYAmt>120000</EOYAmt>
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        <EOYAmt>1712714</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>645889</EOYAmt>
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        <EOYAmt>58349</EOYAmt>
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        <EOYAmt>16805310</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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        <EOYAmt>23003846</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>441986</BOYAmt>
        <EOYAmt>389155</EOYAmt>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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        <PersonNm>RAFFI MILLER</PersonNm>
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        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>SIGNIFICANT PROGRAM SERVICES: HOLYOKE HEALTH CENTER IS PROVIDING IN-HOUSE BEHAVIORAL HEALTH SERVICES FOR OUR PATIENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>PHARMACEUTICAL SERVICES: THE ON-SITE, STATE OF THE ART, COMMUNITY PHARMACY, FILLS APPROXIMATELY 6,000 PRESCRIPTIONS PER WEEK, IS OWNED AND OPERATED BY HOLYOKE HEALTH CENTER AND IS AN INTEGRAL PART OF ALL SERVICES OFFERED IN THE HOLYOKE HEALTH CENTER MEDICAL HOME. BOTH CLINICAL AND DISPENSING PHARMACY STAFF ARE ACTIVE IN HEALTH CENTER COMMITTEES THAT WORK TO CONTINUOUSLY IMPROVE HOLYOKE HEALTH CENTER'S QUALITY, PATIENT CENTERED PROGRAMMING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER PROGRAM SERVICES: TO FURTHER ITS MISSION TO IMPROVE THE HEALTH OF ITS PATIENTS, HOLYOKE HEALTH CENTER OFFERS THE FOLLOWING OUTREACH AND NUTRITIONAL PROGRAMS: - HIV SUPPORT SERVICES AND CASE MANAGEMENT HOLYOKE HEALTH CENTER HAS A COMPREHENSIVE PROGRAM TO SUPPORT PATIENTS LIVING WITH HIV, INCLUDING PRIMARY MEDICAL CARE, INFECTIOUS DISEASE SPECIALISTS WITH EXPERIENCE IN HIV, AND CASE MANAGEMENT SUPPORT TO MEET THE NON-MEDICAL NEEDS OF ITS PATIENTS. THE PHARMACY PROVIDES CONSULTATION WITH A PHARMACIST EXPERIENCED IN HIV MEDICATIONS AND ASSISTANCE WITH ENROLLING IN THE HIV DRUG ASSISTANCE PROGRAM. ALSO AVAILABLE FOR PATIENTS WITH HIV ARE NUTRITION AND EYE CARE SERVICES. - LET'S MOVE HOLYOKE 5-2-1-0 THE LET'S MOVE HOLYOKE 5-2-1-0 IS A COLLABORATIVE INITIATIVE THAT FOCUSES ON THE PROMOTION OF HEALTHY LIVING BY INTEGRATING THE 5-2-1-0 MESSAGE INTO THE COMMUNITY BY USING THE HEALTHY LIVING PLAN FOR CHILDREN AND FAMILY MEMBERS, AS A WAY TO SET GOALS FOR LIFESTYLE CHANGES. - 5 OR MORE FRUITS AND VEGETABLES EACH DAY - 2 HOURS OR LESS OF SCREEN TIME (TV, PHONE, COMPUTER) EACH DAY - 1 HOUR OF PHYSICAL ACTIVITY EACH DAY - 0 SUGAR SWEETENED DRINKS - OPIOID ADDICTION PROGRAM HOLYOKE HEALTH CENTER HAS A COMPREHENSIVE PROGRAM TO SUPPORT PATIENTS LIVING WITH OPIOID ADDICTION, INCLUDING PRIMARY MEDICAL CARE, AND CASE MANAGEMENT SUPPORT TO MEET THE NON-MEDICAL NEEDS OF ITS PATIENTS. - VACCINE OUTREACH PROGRAMS HOLYOKE HEALTH CENTER HAS A COMPREHENSIVE PROGRAM PROVIDING OUTREACH REGARDING MANY TYPES OF ADULT, AND PEDIATRIC VACCINES TO PROMOTE AND IMPROVE THE HEALTH OF ITS PATIENTS. - FAMILY PLANNING PROGRAM HOLYOKE HEALTH CENTER SUPPORTS THE LIVES OF ALL WOMEN BY PROVIDING EVIDENCE-BASED REPRODUCTIVE HEALTH TRAINING AND TECHNICAL ASSISTANCE. - IN-HOUSE BEHAVIORAL HEALTH SERVICES TO BETTER SERVE PATIENTS' NEEDS, HOLYOKE HEALTH CENTER EXPANDED BEHAVIORAL HEALTH ASSESSMENT AND PREVENTION SERVICES TO PROVIDE ON-SITE CARE FOR CHILDREN AND ADULTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>BUSINESS RELATIONSHIPS: ALEJANDRO ESPARZA PEREZ AND BENJAMIN CARTAGENA HAVE A BUSINESS RELATIONSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE BOARD OF DIRECTORS DIRECTED THE CFO TO PRESENT THE 990 FILING (IN DRAFT FORM) TO THE EXECUTIVE/FINANCE COMMITTEE FOR REVIEW. ONCE THE REVIEW HAS BEEN COMPLETED, THE COMMITTEE RECOMMENDS TO THE BOARD OF DIRECTORS THAT THE 990 FILING BE APPROVED BY THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE HOLYOKE HEALTH CENTER INC. REQUIRES NEW EMPLOYEES AND NEWLY APPOINTED MEMBERS OF THE BOARD OF DIRECTORS TO REVIEW AND SIGN THE HOLYOKE HEALTH CENTER INC. CONFLICT OF INTEREST POLICY. THEREAFTER, THE POLICY IS REVIEWED AND SIGNED ANNUALLY BY THE EMPLOYEES AND APPOINTED MEMBERS OF THE BOARD OF DIRECTORS. THE ORGANIZATION'S LEADERS AND BOARD OF DIRECTORS WILL REVIEW ANY RELATIONSHIPS CAREFULLY TO ENSURE THE HEALTH CENTERS' MISSION AND COMMUNITY SERVED IS NOT HARMED BY ANY CONTRACTUAL RELATIONSHIP. DISCIPLINARY ACTIONS CAN RESULT FOR THOSE FAILING TO COMPLY TO THE ORGANIZATION'S CONFLICT OF INTEREST POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEW OF CEO COMPENSATION: THE BOARD OF DIRECTORS ESTABLISHED A SPECIAL COMPENSATION COMMITTEE COMPOSED OF THREE BOARD OF DIRECTOR MEMBERS TO CONDUCT A REVIEW OF THE COMPENSATION PACKAGE FOR THE CEO. DURING THE REVIEW, THIS COMMITTEE CONTACTED THE MASSACHUSETTS LEAGUE OF COMMUNITY HEALTH CENTERS FOR COMPENSATION INFORMATION REGARDING COMPARABLE POSITIONS AND COMPARABLE RESPONSIBILITIES. BASED UPON THAT REVIEW, THE COMMITTEE MADE ITS RECOMMENDATION TO THE BOARD OF DIRECTORS, WHICH WAS ACCEPTED BY THE BOARD. LATEST REVIEW DATE: SPRING 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: THE HOLYOKE HEALTH CENTER INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND ANNUAL INFORMATION RETURNS (FORM 990 SERIES) ARE AVAILABLE TO THE PUBLIC DURING REGULAR BUSINESS HOURS AT THE CENTER'S ADMINISTRATIVE OFFICES AT 230 MAPLE STREET, HOLYOKE, MA 01040-6260.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER CHANGES IN NET ASSETS: $15,659 DISSOLUTION OF CHCCF/HHC DEVELOPMENT LLC</ExplanationTxt>
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