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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>3976735</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>2365031</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>3926199</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
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    <IRS990ScheduleA documentId="IRS990ScheduleA">
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      <SupportingOrgType2Ind>X</SupportingOrgType2Ind>
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          <BusinessNameLine1Txt>ALL CARE VNA OF GREATER LYNN INC</BusinessNameLine1Txt>
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      <SupportedOrgInformationGrp>
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      <SupportedOrgInformationGrp>
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      <Form990SchASupportingOrgGrp>
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        <SuprtOrgNoIRSDeterminationInd>false</SuprtOrgNoIRSDeterminationInd>
        <SupportedOrgSectionC456Ind>false</SupportedOrgSectionC456Ind>
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        <ContributionControllerInd>false</ContributionControllerInd>
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        <ContributorUSAddress>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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      <HeldWorksArtGrp />
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      <CYMinus4YrEndwmtFundGrp />
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        <BookValueAmt>927500</BookValueAmt>
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      <LeaseholdImprovementsGrp />
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      <OtherLandBuildingsGrp>
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      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <TotalLiabilityAmt>0</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>UNDER ASC 740, AN ORGANIZATION MUST RECOGNIZE THE FINANCIAL STATEMENT EFFECTS OF A TAX POSITION TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL NOT BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. THE ORGANIZATION DOES NOT BELIEVE IT HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS, AND ACCORDINGLY, IT HAS NOT RECORDED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE ORGANIZATION HAS FILED FOR AND RECEIVED INCOME TAX EXEMPTIONS IN THE JURISDICTIONS WHERE IT IS REQUIRED TO DO SO. ADDITIONALLY, THE ORGANIZATION HAS FILED ALL APPLICABLE RETURNS IN JURISDICTIONS WHERE SO REQUIRED. FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, THERE WERE NO INTEREST OR PENALTIES RECORDED OR INCLUDED IN THE CONSOLIDATED STATEMENTS OF ACTIVITIES.</ExplanationTxt>
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        <CharitableContributionsTotAmt>49622</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>29537</GrossRevenueTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>31039</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>31039</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-1502</NetIncomeSummaryAmt>
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      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
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      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
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      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <TitleTxt>CFO/Senior VP</TitleTxt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
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        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S SOLE CORPORATE MEMBER, HEALTH MANAGEMENT SERVICES, INC., USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO; A COMPENSATION COMMITTEE, FORM 990 OF OTHER ORGANIZATIONS, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION STUDY OR SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.</ExplanationTxt>
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        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>false</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K, PART I, BOND ISSUES:</FormAndLineReferenceDesc>
        <ExplanationTxt>(A) ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY (F) DESCRIPTION OF PURPOSE: TO FINANCE CONSTRUCTION OF CORPORATE HEADQUARTERS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S SOLE CORPORATE MEMBER, HEALTH MANAGEMENT SYSTEMS, INC. IS IN CHARGE OF MANAGEMENT DUTIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY AT THE HMS, INC. EXECUTIVE COMMITTEE MEETING BEFORE IT IS SIGNED AND FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THROUGH ORIENTATION AND ANNUAL EDUCATION. ENFORCEMENT HAS NOT BEEN AN ISSUE, BUT WOULD OCCUR IF NECESSARY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 18:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AS WELL AS AT THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCIAL STATEMENTS ARE AVAILABLE UPON PUBLIC REQUEST AS WELL AS AT THE MASSACHUSETTS ATTORNEY GENERAL WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9, CHANGE IN NET ASSETS:</FormAndLineReferenceDesc>
        <ExplanationTxt>INTERCOMPANY EQUITY ADJUSTMENTS $ 3,926,199.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALL CARE RESOURCES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>042805564</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HMS Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HEALTH MANAGEMENT SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>222581863</EIN>
        <PrimaryActivitiesTxt>Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALL CARE HOSPICE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>352231860</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HMS Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALL CARE VNA OF GREATER LYNN INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>042214847</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HMS Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>VNA VENTURES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>042942852</EIN>
        <PrimaryActivitiesTxt>Real Estate</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>hms inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C-Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <OwnershipPct>0.00000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ALL CARE INFUSION COMPANY INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>043120267</EIN>
        <PrimaryActivitiesTxt>Health SVCS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>vna ventures</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C-Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <OwnershipPct>0.00000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>