<?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="2021v4.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-06-20T16:21:19-05:00</ReturnTs>
    <TaxPeriodEndDt>2022-08-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>042571780</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>AAFCPAS INC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>50 WASHINGTON STREET</AddressLine1Txt>
        <CityNm>WESTBOROUGH</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>01581</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2021-09-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>050355097</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>THUNDERMIST HEALTH CENTER</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>THUN</BusinessNameControlTxt>
      <PhoneNum>4017674163</PhoneNum>
      <USAddress>
        <AddressLine1Txt>25 JOHN A CUMMINGS WAY</AddressLine1Txt>
        <CityNm>WOONSOCKET</CityNm>
        <StateAbbreviationCd>RI</StateAbbreviationCd>
        <ZIPCd>02895</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>JEANNE LACHANCE</PersonNm>
      <PersonTitleTxt>CHIEF EXECUTIVE OFFICER</PersonTitleTxt>
      <PhoneNum>4017674163</PhoneNum>
      <SignatureDt>2023-06-16</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>JEANNE</PersonFirstNm>
        <PersonLastNm>LACHANCE</PersonLastNm>
      </PersonFullName>
      <SSN>XXX-XX-XXXX</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>COURTNEY MCFARLAND CPA</PreparerPersonNm>
      <PTIN>P01645518</PTIN>
      <PhoneNum>5083669100</PhoneNum>
      <PreparationDt>2023-06-16</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2021</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="10">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>JEANNE LACHANCE</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>171 SERVICE AVENUE BUILDING 2</AddressLine1Txt>
        <CityNm>WARWICK</CityNm>
        <StateAbbreviationCd>RI</StateAbbreviationCd>
        <ZIPCd>02886</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>103322331</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.THUNDERMISTHEALTH.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1969</FormationYr>
      <LegalDomicileStateCd>RI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITIES BY DELIVERING EXCEPTIONAL HEALTH CARE, REMOVING BARRIERS TO THAT CARE AND PROMOTING HEALTHY LIFESTYLES.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>14</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>14</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>910</TotalEmployeeCnt>
      <TotalVolunteersCnt>14</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>14745785</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>16147967</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>75444717</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>86632773</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>40160</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>23768</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>750920</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>234265</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>90981582</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>103038773</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>59067923</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>64338321</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>29000</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>12000</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>582224</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>29018066</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>35789143</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>88114989</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>100139464</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>2866593</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>2899309</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>55440960</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>60584911</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>21118600</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>23363242</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>34322360</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>37221669</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITIES BY DELIVERING EXCEPTIONAL HEALTH CARE, REMOVING BARRIERS TO THAT CARE AND PROMOTING HEALTHY LIFESTYLES.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>83315701</ExpenseAmt>
      <RevenueAmt>86632773</RevenueAmt>
      <Desc>TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITIES BY DELIVERING EXCEPTIONAL HEALTH CARE, REMOVING BARRIERS TO THAT CARE AND PROMOTING HEALTHY LIFESTYLES. DURING THE FISCAL YEAR, WE SERVED OVER 57,000 PATIENTS WITH OVER 314,000 MEDICAL AND DENTAL VISITS.</Desc>
      <TotalProgramServiceExpensesAmt>83315701</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039600001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039600001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039600001">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">1</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 referenceDocumentId="RetDoc1053100001">1</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>0</InvestTaxExemptBondsInd>
      <EscrowAccountInd>0</EscrowAccountInd>
      <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">0</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">1</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">1</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>65</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>910</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>14</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>14</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</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>1</LocalChaptersInd>
      <PoliciesReferenceChaptersInd>1</PoliciesReferenceChaptersInd>
      <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>RI</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>CHETNA CHANDRAKALA CFO</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>4017674100</PhoneNum>
        <USAddress>
          <AddressLine1Txt>25 JOHN A CUMMINGS WAY</AddressLine1Txt>
          <CityNm>WOONSOCKET</CityNm>
          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02895</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREA ROLLIN</PersonNm>
        <TitleTxt>CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIN COONEY</PersonNm>
        <TitleTxt>VICE CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>M DOUGLAS FAY</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINDA CANNISTRA</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID VALOIS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY ELLEN CANIGLIA</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MADRONE PHOENIX</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY HENRY PHD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHERYL KING</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DONALD LARSEN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAWRENCE TRIM</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VICTORIA MARKEY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RANDALL RICE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KRISTINA CONTRERAS FOX</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANDRA ENOS PHD</PersonNm>
        <TitleTxt>DIRECTOR (UNTIL 2/2022)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIC BEANE</PersonNm>
        <TitleTxt>DIRECTOR (UNTIL 3/2022)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHANIE MANDEVILLE</PersonNm>
        <TitleTxt>DIRECTOR (UNTIL 5/2022)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEANNE LACHANCE</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>250177</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25170</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LUCIA SILVA</PersonNm>
        <TitleTxt>CFO (UNTIL 9/2021)</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>122886</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15388</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID M BOURASSA</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>292223</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33341</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIC J PROSSEDA</PersonNm>
        <TitleTxt>DENTAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>327521</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27400</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINDA BERMAN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>278279</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6857</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JESSICA JOHNSON</PersonNm>
        <TitleTxt>ASSOCIATE MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>238447</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14102</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ARNOLD GOLDBERG</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>278107</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22125</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER BUCKLEY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>240924</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13779</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2028564</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>158162</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>112</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SCANSTAT TECHNOLOGIES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 791522</AddressLine1Txt>
            <CityNm>BALTIMORE</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21279</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTH INFORMATION MANAGEMENT</ServicesDesc>
        <CompensationAmt>466220</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>VISION 3 ARCHITECTS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>225 CHAPMAN ST</AddressLine1Txt>
            <CityNm>PROVIDENCE</CityNm>
            <StateAbbreviationCd>RI</StateAbbreviationCd>
            <ZIPCd>02905</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
        <CompensationAmt>146228</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PACIFIC INTERPRETERS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 204313</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>753204313</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>INTERPRETING SERVICES</ServicesDesc>
        <CompensationAmt>136891</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>3</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>13212440</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>2935527</AllOtherContributionsAmt>
      <TotalContributionsAmt>16147967</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621498</BusinessCd>
        <TotalRevenueColumnAmt>86632773</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>86632773</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>86632773</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>23768</TotalRevenueColumnAmt>
        <ExclusionAmt>23768</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>251214</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>283558</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>-32344</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-32344</TotalRevenueColumnAmt>
        <ExclusionAmt>-32344</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>266609</TotalRevenueColumnAmt>
        <ExclusionAmt>266609</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>266609</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>103038773</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>86632773</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>258033</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>737531</TotalAmt>
        <ProgramServicesAmt>222902</ProgramServicesAmt>
        <ManagementAndGeneralAmt>514629</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>51131826</TotalAmt>
        <ProgramServicesAmt>42484035</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8376882</ManagementAndGeneralAmt>
        <FundraisingAmt>270909</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1579975</TotalAmt>
        <ProgramServicesAmt>1232757</ProgramServicesAmt>
        <ManagementAndGeneralAmt>338438</ManagementAndGeneralAmt>
        <FundraisingAmt>8780</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>7257529</TotalAmt>
        <ProgramServicesAmt>5616237</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1601793</ManagementAndGeneralAmt>
        <FundraisingAmt>39499</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>3631460</TotalAmt>
        <ProgramServicesAmt>2796195</ProgramServicesAmt>
        <ManagementAndGeneralAmt>815639</ManagementAndGeneralAmt>
        <FundraisingAmt>19626</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>72000</TotalAmt>
        <ManagementAndGeneralAmt>72000</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>231151</TotalAmt>
        <ManagementAndGeneralAmt>231151</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>30000</TotalAmt>
        <ManagementAndGeneralAmt>30000</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>12000</TotalAmt>
        <FundraisingAmt>12000</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForServicesOtherGrp>
        <TotalAmt>4093637</TotalAmt>
        <ProgramServicesAmt>2925769</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1165493</ManagementAndGeneralAmt>
        <FundraisingAmt>2375</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>111766</TotalAmt>
        <ProgramServicesAmt>800</ProgramServicesAmt>
        <ManagementAndGeneralAmt>948</ManagementAndGeneralAmt>
        <FundraisingAmt>110018</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>908170</TotalAmt>
        <ProgramServicesAmt>682755</ProgramServicesAmt>
        <ManagementAndGeneralAmt>170365</ManagementAndGeneralAmt>
        <FundraisingAmt>55050</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>2424072</TotalAmt>
        <ProgramServicesAmt>2314253</ProgramServicesAmt>
        <ManagementAndGeneralAmt>109819</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>3019093</TotalAmt>
        <ProgramServicesAmt>1418218</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1600875</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>78530</TotalAmt>
        <ProgramServicesAmt>55481</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20382</ManagementAndGeneralAmt>
        <FundraisingAmt>2667</FundraisingAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1726005</TotalAmt>
        <ProgramServicesAmt>1076001</ProgramServicesAmt>
        <ManagementAndGeneralAmt>650004</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>315054</TotalAmt>
        <ProgramServicesAmt>67567</ProgramServicesAmt>
        <ManagementAndGeneralAmt>247487</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES AND PH</Desc>
        <TotalAmt>20923932</TotalAmt>
        <ProgramServicesAmt>20899854</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23735</ManagementAndGeneralAmt>
        <FundraisingAmt>343</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>STAFF TRAINING AND RECR</Desc>
        <TotalAmt>685291</TotalAmt>
        <ProgramServicesAmt>520119</ProgramServicesAmt>
        <ManagementAndGeneralAmt>161225</ManagementAndGeneralAmt>
        <FundraisingAmt>3947</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LAB EXPENSES</Desc>
        <TotalAmt>554706</TotalAmt>
        <ProgramServicesAmt>554706</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES, SUBSCRIPTIONS, AN</Desc>
        <TotalAmt>317727</TotalAmt>
        <ProgramServicesAmt>204669</ProgramServicesAmt>
        <ManagementAndGeneralAmt>105453</ManagementAndGeneralAmt>
        <FundraisingAmt>7605</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>298009</TotalAmt>
        <ProgramServicesAmt>243383</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5221</ManagementAndGeneralAmt>
        <FundraisingAmt>49405</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>100139464</TotalAmt>
        <ProgramServicesAmt>83315701</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16241539</ManagementAndGeneralAmt>
        <FundraisingAmt>582224</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>4657832</BOYAmt>
        <EOYAmt>4032762</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>10173745</BOYAmt>
        <EOYAmt>14777800</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>969969</BOYAmt>
        <EOYAmt>772803</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>7127406</BOYAmt>
        <EOYAmt>5676248</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>653931</BOYAmt>
        <EOYAmt>556840</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>46050685</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>12507893</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>31437688</BOYAmt>
        <EOYAmt>33542792</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>420389</BOYAmt>
        <EOYAmt>1225666</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>55440960</BOYAmt>
        <EOYAmt>60584911</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>10019694</BOYAmt>
        <EOYAmt>12101982</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>1860750</BOYAmt>
        <EOYAmt>1653999</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>9238156</BOYAmt>
        <EOYAmt>8814148</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>793113</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>21118600</BOYAmt>
        <EOYAmt>23363242</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>33298491</BOYAmt>
        <EOYAmt>35373248</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>1023869</BOYAmt>
        <EOYAmt>1848421</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>34322360</BOYAmt>
        <EOYAmt>37221669</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>55440960</BOYAmt>
        <EOYAmt>60584911</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>2899309</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>9628124</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>10458918</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12753415</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>14745785</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>16147967</CurrentTaxYearAmt>
        <TotalAmt>63734209</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>45408722</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>56568105</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>66676423</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>75444717</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>86632773</CurrentTaxYearAmt>
        <TotalAmt>330730740</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>55036846</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>67027023</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>79429838</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>90190502</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>102780740</CurrentTaxYearAmt>
        <TotalAmt>394464949</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>73625</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>13830</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>35000</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>37500</CurrentTaxYearAmt>
        <TotalAmt>159955</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>73625</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>13830</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>35000</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>37500</CurrentTaxYearAmt>
        <TotalAmt>159955</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>394304994</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>148042</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>178359</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>542475</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>333800</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>274982</CurrentTaxYearAmt>
        <TotalAmt>1477658</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>148042</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>178359</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>542475</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>333800</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>274982</CurrentTaxYearAmt>
        <TotalAmt>1477658</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>323915</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>73698</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>584466</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>765190</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>266609</CurrentTaxYearAmt>
        <TotalAmt>2013878</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>55508803</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>67279080</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>80556779</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>91289492</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>103322331</CurrentTaxYearAmt>
        <TotalAmt>397956485</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99080</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99050</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00370</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00390</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MISCELLANEOUS - 2017 AMOUNT: $ 323,915. 2018 AMOUNT: $ 73,698. 2019 AMOUNT: $ 584,466. 2020 AMOUNT: $ 765,190. 2021 AMOUNT: $ 266,609.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039600001">
      <TotalDirectLobbyingGrp>
        <FilingOrganizationsTotalAmt>30000</FilingOrganizationsTotalAmt>
      </TotalDirectLobbyingGrp>
      <TotalLobbyingExpendGrp>
        <FilingOrganizationsTotalAmt>30000</FilingOrganizationsTotalAmt>
      </TotalLobbyingExpendGrp>
      <OtherExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>100393022</FilingOrganizationsTotalAmt>
      </OtherExemptPurposeExpendGrp>
      <TotalExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>100423022</FilingOrganizationsTotalAmt>
      </TotalExemptPurposeExpendGrp>
      <LobbyingNontaxableAmountGrp>
        <FilingOrganizationsTotalAmt>1000000</FilingOrganizationsTotalAmt>
      </LobbyingNontaxableAmountGrp>
      <GrassrootsNontaxableGrp>
        <FilingOrganizationsTotalAmt>250000</FilingOrganizationsTotalAmt>
      </GrassrootsNontaxableGrp>
      <TotLbbyngGrassrootMnsNonTxGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </TotLbbyngGrassrootMnsNonTxGrp>
      <TotLbbyExpendMnsLbbyngNonTxGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </TotLbbyExpendMnsLbbyngNonTxGrp>
      <AvgLobbyingNontaxableAmountGrp>
        <CurrentYearMinus3Amt>1000000</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>1000000</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>1000000</CurrentYearMinus1Amt>
        <CurrentYearAmt>1000000</CurrentYearAmt>
        <TotalAmt>4000000</TotalAmt>
      </AvgLobbyingNontaxableAmountGrp>
      <LobbyingCeilingAmt>6000000</LobbyingCeilingAmt>
      <AvgTotalLobbyingExpendGrp>
        <CurrentYearMinus3Amt>15000</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>27750</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>32500</CurrentYearMinus1Amt>
        <CurrentYearAmt>30000</CurrentYearAmt>
        <TotalAmt>105250</TotalAmt>
      </AvgTotalLobbyingExpendGrp>
      <AvgGrassrootsNontaxableGrp>
        <CurrentYearMinus3Amt>250000</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>250000</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>250000</CurrentYearMinus1Amt>
        <CurrentYearAmt>250000</CurrentYearAmt>
        <TotalAmt>1000000</TotalAmt>
      </AvgGrassrootsNontaxableGrp>
      <GrassrootsCeilingAmt>1500000</GrassrootsCeilingAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-A, LINE 1B:</FormAndLineReferenceDesc>
        <ExplanationTxt>CONSULTANTS WORK FOR THUNDERMIST HEALTH CENTER INCLUDE SETTING UP MEETINGS WITH PERTINENT POLICY LEADERS, DEVELOPING TALKING POINTS FOR CLIENT AND MESSAGING FOR HEARINGS AND MEETINGS, AND MONITORING THE STATE BUDGET PROPOSAL AND REVIEWING FOR IMPACT TO THUNDERMIST HEALTH CENTER.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>2556058</OtherCostOrOtherBasisAmt>
        <BookValueAmt>2556058</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>33308465</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>7933320</DepreciationAmt>
        <BookValueAmt>25375145</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>868065</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>261107</DepreciationAmt>
        <BookValueAmt>606958</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>5642879</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4313466</DepreciationAmt>
        <BookValueAmt>1329413</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>3675218</OtherCostOrOtherBasisAmt>
        <BookValueAmt>3675218</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>33542792</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>CONDITIONAL GRANT ADVANCE</Desc>
        <Amt>793113</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>793113</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AGENCY ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES IN ACCORDANCE WITH ASC TOPIC, INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE CONSOLIDATED FINANCIAL STATEMENTS REGARDING A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE AGENCY HAS DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS WHICH QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS AT AUGUST 31, 2022. THE AGENCY'S INFORMATION RETURNS ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE JURISDICTION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <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>ERIC J PROSSEDA</PersonNm>
        <TitleTxt>DENTAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>275380</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>52141</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8728</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18672</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>354921</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID M BOURASSA</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <BaseCompensationFilingOrgAmt>279191</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>13032</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14669</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18672</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>325564</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ARNOLD GOLDBERG</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>276373</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1734</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6273</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15852</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>300232</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LINDA BERMAN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>247372</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>30907</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6368</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>489</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>285136</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JEANNE LACHANCE</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>228255</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>21922</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6498</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18672</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>275347</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JENNIFER BUCKLEY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>238995</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1929</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5831</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7948</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>254703</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JESSICA JOHNSON</PersonNm>
        <TitleTxt>ASSOCIATE MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>232983</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5464</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6562</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7540</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>252549</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>RHODE ISLAND EDUCATIONAL AND BUILDING ASSOCIATION</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuedDt>2010-08-02</BondIssuedDt>
        <IssuePriceAmt>4135000</IssuePriceAmt>
        <PurposeDesc>TO REFINANCE EXISTING TAX-EXEMPT BOND FOR A LOWER INTEREST RATE</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>2481001</RetiredAmt>
        <TotalProceedsAmt>4135000</TotalProceedsAmt>
        <WorkingCapitalExpendituresAmt>4135000</WorkingCapitalExpendituresAmt>
        <SubstantialCompletionYr>2009</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>0</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>JEANNE ZITER MD</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>WIFE OF KEY EMPLOYEE DAVID BOURASSA, MD.</RelationshipDescriptionTxt>
        <TransactionAmt>126903</TransactionAmt>
        <TransactionDesc>JEANNE ZITER, MD. IS EMPLOYED BY THUNDERMIST AS A PEDIATRICIAN.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 IS PRESENTED TO THE GOVERNING BODY FOR APPROVAL BEFORE BEING FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ON AN ANNUAL BASIS THE ORGANIZATION REQUIRES ALL BOARD MEMBERS, CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND SENIOR VICE PRESIDENTS TO DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICT. THIS INFORMATION IS REQUIRED TO BE COMPLETED AND RETURNED TO THE ADMINISTRATIVE SERVICES COORDINATOR FOR FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION USES THE ANNUAL SURVEY COMPLETED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS TO DETERMINE THE COMPENSATION OF THE CEO, EXECUTIVE DIRECTOR KEY EMPLOYEES AND TOP MANAGEMENT OFFICIALS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS A FINANCE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE SELECTION OF THE INDEPENDENT AUDITORS, OVERSIGHT OF THE ANNUAL FINANCIAL STATEMENT AUDIT, AND APPROVAL OF THE FINANCIAL STATEMENTS. ONCE APPROVED, THE FINANCIAL STATEMENTS ARE PRESENTED TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL. THIS POLICY HAS NOT CHANGED FROM THE PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THC MANAGER LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>25 JOHN A CUMMINGS WAY</AddressLine1Txt>
          <CityNm>WOONSOCKET</CityNm>
          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02895</ZIPCd>
        </USAddress>
        <EIN>364716323</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>RI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>THUNDERMIST HEALTH CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THC DEVELOPMENT COMPANY LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>25 JOHN A CUMMINGS WAY</AddressLine1Txt>
          <CityNm>WOONSOCKET</CityNm>
          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02895</ZIPCd>
        </USAddress>
        <EIN>371655355</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>RI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>THUNDERMIST HEALTH CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE LANDLORD LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>25 JOHN A CUMMINGS WAY</AddressLine1Txt>
          <CityNm>WOONSOCKET</CityNm>
          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02895</ZIPCd>
        </USAddress>
        <EIN>274499053</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>RI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>THUNDERMIST HEALTH CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE MT LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>25 JOHN A CUMMINGS WAY</AddressLine1Txt>
          <CityNm>WOONSOCKET</CityNm>
          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02895</ZIPCd>
        </USAddress>
        <EIN>274498874</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>RI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>THUNDERMIST HEALTH CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
