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        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SISTER BETSY CONWAY CSJ</PersonNm>
        <TitleTxt>COMMUNITY COUNCILOR (UNTIL 06/25)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SISTER GAIL DONAHUE</PersonNm>
        <TitleTxt>COMMUNITY COUNCILOR (UNTIL 06/25)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SISTER MARY ELLEN O'CONNELL</PersonNm>
        <TitleTxt>COMMUNITY COUNCILOR (UNTIL 06/25)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>945589</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>131780</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>11</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ALLIANCE HEALTH MANAGEMENT SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>144 TURNPIKE RD</AddressLine1Txt>
            <CityNm>SOUTHBOROUGH</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01772</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MANAGEMENT COMPANY</ServicesDesc>
        <CompensationAmt>624098</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>OMNI HEALTHCARE STAFFING</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>390 MAIN ST SUITE 734</AddressLine1Txt>
            <CityNm>WORCESTER</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01608</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT NURSING SERVICES</ServicesDesc>
        <CompensationAmt>588482</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>INTRIGUE NURSING SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>12 DUNADERRY WAY</AddressLine1Txt>
            <CityNm>PAXTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01612</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT NURSING SERVICES</ServicesDesc>
        <CompensationAmt>481535</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>UNIQUE NURSING STAFFING AGENCY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>121 LINCOLN ST</AddressLine1Txt>
            <CityNm>WORCESTER</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01605</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT NURSING SERVICES</ServicesDesc>
        <CompensationAmt>453000</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>KIMS NURSING STAFFING AGENCY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>65 JAMES ST</AddressLine1Txt>
            <CityNm>WORCESTER</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01603</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT NURSING SERVICES</ServicesDesc>
        <CompensationAmt>238863</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>2900000</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>226625</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>985690</AllOtherContributionsAmt>
      <TotalContributionsAmt>4112315</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUES</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>12505721</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>12505721</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ST JOSEPH HALL MEAL PROGRAM</Desc>
        <BusinessCd>624200</BusinessCd>
        <TotalRevenueColumnAmt>301998</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>301998</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>74033</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>74033</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>12881752</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>10757</TotalRevenueColumnAmt>
        <ExclusionAmt>10757</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>37078</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>778</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>37078</SecuritiesAmt>
        <OtherAmt>-778</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>36300</TotalRevenueColumnAmt>
        <ExclusionAmt>36300</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>SPECTRA-AMERICAN TOWER EASEMENT</Desc>
        <BusinessCd>531190</BusinessCd>
        <TotalRevenueColumnAmt>1509</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>1509</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>1509</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>17042633</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>12881752</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>1509</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>47057</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>122750</TotalAmt>
        <ManagementAndGeneralAmt>122750</ManagementAndGeneralAmt>
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      <OtherSalariesAndWagesGrp>
        <TotalAmt>8446379</TotalAmt>
        <ProgramServicesAmt>7538384</ProgramServicesAmt>
        <ManagementAndGeneralAmt>686140</ManagementAndGeneralAmt>
        <FundraisingAmt>221855</FundraisingAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>370243</TotalAmt>
        <ProgramServicesAmt>333060</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32050</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
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        <ProgramServicesAmt>798541</ProgramServicesAmt>
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        <FundraisingAmt>12308</FundraisingAmt>
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      <PayrollTaxesGrp>
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        <TotalAmt>680834</TotalAmt>
        <ManagementAndGeneralAmt>680834</ManagementAndGeneralAmt>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>348</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
        <TotalAmt>87704</TotalAmt>
        <ManagementAndGeneralAmt>87704</ManagementAndGeneralAmt>
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      <FeesForServicesLobbyingGrp>
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        <ManagementAndGeneralAmt>2035</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
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      <AdvertisingGrp>
        <TotalAmt>15854</TotalAmt>
        <ManagementAndGeneralAmt>15854</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>19747</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21281</ManagementAndGeneralAmt>
        <FundraisingAmt>29004</FundraisingAmt>
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      <InformationTechnologyGrp>
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      <TravelGrp>
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        <ProgramServicesAmt>1462</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2510</ManagementAndGeneralAmt>
        <FundraisingAmt>4</FundraisingAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>5697</TotalAmt>
        <ProgramServicesAmt>46</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5651</ManagementAndGeneralAmt>
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      <InterestGrp>
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      <InsuranceGrp>
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        <ProgramServicesAmt>782261</ProgramServicesAmt>
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        <FundraisingAmt>844</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>USER FEES</Desc>
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        <ProgramServicesAmt>710690</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES &amp; DRUG</Desc>
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        <ProgramServicesAmt>394185</ProgramServicesAmt>
        <ManagementAndGeneralAmt>108</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>BAD DEBT</Desc>
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        <ManagementAndGeneralAmt>30271</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>80236</TotalAmt>
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        <ManagementAndGeneralAmt>46608</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>17108048</TotalAmt>
        <ProgramServicesAmt>14569367</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2230928</ManagementAndGeneralAmt>
        <FundraisingAmt>307753</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>1022796</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
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      <AccountsReceivableGrp>
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        <EOYAmt>1106365</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>87048</BOYAmt>
        <EOYAmt>59252</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>23461951</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>5166542</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>736339</EOYAmt>
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      <OtherAssetsTotalGrp>
        <BOYAmt>891536</BOYAmt>
        <EOYAmt>952764</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>9304378</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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      <DeferredRevenueGrp>
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      <OtherLiabilitiesGrp>
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        <EOYAmt>3378784</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>5759784</BOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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      <DonorRestrictionNetAssetsGrp>
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      <TotLiabNetAssetsFundBalanceGrp>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
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    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
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        <CurrentTaxYearAmt>16994067</CurrentTaxYearAmt>
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      <SubstAndDsqlfyPrsnsTotGrp>
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        <CurrentTaxYearMinus1YearAmt>9135</CurrentTaxYearMinus1YearAmt>
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      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearMinus1YearAmt>9135</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10757</CurrentTaxYearAmt>
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      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
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        <CurrentTaxYearMinus2YearsAmt>8014</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7307</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1509</CurrentTaxYearAmt>
        <TotalAmt>126830</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
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        <TotalAmt>52521</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
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        <CurrentTaxYearMinus2YearsAmt>18480092</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>19311790</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>17006333</CurrentTaxYearAmt>
        <TotalAmt>92728637</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99760</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99730</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00040</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00040</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>GROSS FUNDRAISING - 2024 AMOUNT: $ 2,541. INSURANCE PROCEEDS - 2024 AMOUNT: $ 49,980.</ExplanationTxt>
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