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        <TitleTxt>Senior Vice President Corporate Secretary</TitleTxt>
        <AverageHoursPerWeekRt>035.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>005.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>275227</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25168</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James L Beckmann JD</PersonNm>
        <TitleTxt>Assistant Corporate Secretary</TitleTxt>
        <AverageHoursPerWeekRt>035.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>005.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>169941</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32011</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jodi L Probst</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Peter P Jones</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Laurine M Garrity</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Helen A Fox-O'Brien</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Thomas J Culhane</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kathleen F Driscoll</PersonNm>
        <TitleTxt>Chair Elect</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Joni W Wheeler</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Linda A LeBlanc PhD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Sherrye Hutcherson</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Thomas Barker</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mark Tilden</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rick Velasco</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dorothy Zolandz</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Nkogo-Nze</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Janet S Twyman</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kathy Nieland</PersonNm>
        <TitleTxt>Director - through March 2023</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>William M Bryant</PersonNm>
        <TitleTxt>Director - through March 2023</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Bradley Welling</PersonNm>
        <TitleTxt>Director - through March 2023</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Keith Allen</PersonNm>
        <TitleTxt>Director - through March 2023</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Richard Chole</PersonNm>
        <TitleTxt>Director - through November 2023</TitleTxt>
        <AverageHoursPerWeekRt>002.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>7438085</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>559889</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>346</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Mercy Health</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 505125</AddressLine1Txt>
            <CityNm>Saint Louis</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>63150</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Licensing Fees</ServicesDesc>
        <CompensationAmt>4720027</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Medical Solutions LLC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 310859</AddressLine1Txt>
            <CityNm>Des Moines</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>503310859</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Temporary Staffing</ServicesDesc>
        <CompensationAmt>3033764</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Facebook</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1601 Willow Road</AddressLine1Txt>
            <CityNm>Menlo Park</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>94028</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Marketing Fees</ServicesDesc>
        <CompensationAmt>2874178</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>UNMC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>987137 Nebraska Medical Center</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68198</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Pathology</ServicesDesc>
        <CompensationAmt>1744774</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>CrossVue LLC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1600 Tysons Blvd Suite 1100</AddressLine1Txt>
            <CityNm>McLean</CityNm>
            <StateAbbreviationCd>VA</StateAbbreviationCd>
            <ZIPCd>22102</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Consulting Services</ServicesDesc>
        <CompensationAmt>1010818</CompensationAmt>
      </ContractorCompensationGrp>
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      <FundraisingAmt>701733</FundraisingAmt>
      <RelatedOrganizationsAmt>53362000</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>33100055</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>118611093</AllOtherContributionsAmt>
      <NoncashContributionsAmt>5481919</NoncashContributionsAmt>
      <TotalContributionsAmt>205774881</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Boys Town National Research Hospital</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>192125293</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>192125293</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Nebraska/Iowa Services</Desc>
        <BusinessCd>623990</BusinessCd>
        <TotalRevenueColumnAmt>28586114</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>28586114</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Home Town Educational</Desc>
        <BusinessCd>611420</BusinessCd>
        <TotalRevenueColumnAmt>7950285</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7950285</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>National Hotline and Public Services</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>8287777</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8287777</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>236949469</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>9689836</TotalRevenueColumnAmt>
        <ExclusionAmt>9689836</ExclusionAmt>
      </InvestmentIncomeGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>260871</TotalRevenueColumnAmt>
        <ExclusionAmt>260871</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>103754</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>103754</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>103754</TotalRevenueColumnAmt>
        <ExclusionAmt>103754</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>706961915</SecuritiesAmt>
        <OtherAmt>10000</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>702357303</SecuritiesAmt>
        <OtherAmt>29510</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>4604612</SecuritiesAmt>
        <OtherAmt>-19510</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>4585102</TotalRevenueColumnAmt>
        <ExclusionAmt>4585102</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>205031</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>697204</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>347692</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-142661</TotalRevenueColumnAmt>
        <ExclusionAmt>-142661</ExclusionAmt>
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      <GamingGrossIncomeAmt>4530</GamingGrossIncomeAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>4530</TotalRevenueColumnAmt>
        <ExclusionAmt>4530</ExclusionAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>216296</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>112819</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>103477</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>103477</UnrelatedBusinessRevenueAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>Mail List Rental</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>581845</TotalRevenueColumnAmt>
        <ExclusionAmt>581845</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Village Services</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>405507</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>405507</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>FSA Forfeitures</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>398426</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>398426</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>1419049</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1419049</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>2804827</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>460134086</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>239172451</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>103477</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>15083277</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>23210306</TotalAmt>
        <ProgramServicesAmt>23210306</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>5174392</TotalAmt>
        <ProgramServicesAmt>5174392</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>3193519</TotalAmt>
        <ProgramServicesAmt>818996</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2374523</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>208583631</TotalAmt>
        <ProgramServicesAmt>193854081</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10118980</ManagementAndGeneralAmt>
        <FundraisingAmt>4610570</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>10035028</TotalAmt>
        <ProgramServicesAmt>9037714</ProgramServicesAmt>
        <ManagementAndGeneralAmt>754367</ManagementAndGeneralAmt>
        <FundraisingAmt>242947</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>43333298</TotalAmt>
        <ProgramServicesAmt>40195760</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2123154</ManagementAndGeneralAmt>
        <FundraisingAmt>1014384</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>14253629</TotalAmt>
        <ProgramServicesAmt>13076277</ProgramServicesAmt>
        <ManagementAndGeneralAmt>848310</ManagementAndGeneralAmt>
        <FundraisingAmt>329042</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>835632</TotalAmt>
        <ManagementAndGeneralAmt>835632</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>242296</TotalAmt>
        <ManagementAndGeneralAmt>242296</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>179015</TotalAmt>
        <ProgramServicesAmt>179015</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising></FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>796279</TotalAmt>
        <ManagementAndGeneralAmt>796279</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>25038364</TotalAmt>
        <ProgramServicesAmt>20552163</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3202335</ManagementAndGeneralAmt>
        <FundraisingAmt>1283866</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>6788029</TotalAmt>
        <ProgramServicesAmt>3639636</ProgramServicesAmt>
        <ManagementAndGeneralAmt>721116</ManagementAndGeneralAmt>
        <FundraisingAmt>2427277</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>82752874</TotalAmt>
        <ProgramServicesAmt>34320800</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1663733</ManagementAndGeneralAmt>
        <FundraisingAmt>46768341</FundraisingAmt>
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        <ExplanationTxt>Father Flanagans Boys Home, 14100 Crawford Street, Boys Town NE 68010, 47-0376606, 477,959,598, 179,015 Father Flanagans Fund for Needy Children, 14100 Crawford Street, Boys Town, NE 68010, 36-3680258, 56,233,535, 0 Boys Town California, Inc., 14100 Crawford Street, Boys Town, NE 68010, 76-0720675, 55, 0 Boys Town Central Florida, Inc., 975 Oklahoma Street, Oviedo, FL 32765, 20-0654235, 7,204,643, 0 Boys Town Louisiana, Inc., 300 North Broad Street, Ste. 106, New Orleans, LA 70119, 41-2220807, 10,382,050, 0 Boys Town Nevada, Inc. 821 N Mojave Road., Las Vegas, NV 89101, 20-0654472, 11,660,136, 14,000 Boys Town New England, Inc., Barzarsky Campus 58 Flanagan Road., Portsmouth, RI 02871, 20-0655240, 9,913,671, 0 Boys Town New York, Inc., 14100 Crawford Street, Boys Town, NE 68010, 20-5960877, 601, 0 Boys Town North Florida, Inc., 3555 Commonwealth Blvd. Tallahassee, FL 32303, 20-0655144, 7,121,439, 0 Boys Town Washington D.C. Inc., 4801 Sargent Rd N.E., Washington, DC 20017, 41-2220810, 4,373,789, 0 Boys Town South Florida, Inc., 1655 Palm Beach Lakes Blvd., West Palm Beach, FL 33401, 26-3965524, 8,283,647, 0 Lied Learning and Technology Center for Childhood Deafness and Vision Disorders, 14100 Crawford Street, Boys Town, NE 68010, 47-0841263, 4,906,507, 0</ExplanationTxt>
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        <ExplanationTxt>The intended uses of the organizations endowment funds are to support the activities of Father Flanagans Boys Home in fulfilling its mission in compliance with donor intent.</ExplanationTxt>
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        <ExplanationTxt>To solicit input from key informants, those individuals who have a broad interest in the health of children and adolescents in the community, an Online Key Informant Survey was implemented as part of this process. A list of recommended participants was provided by the sponsors of the study this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of community leaders. Potential participants were chosen because of their ability to identify primary concerns among the families and children/adolescents with whom they work with, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online reminder emails were sent as needed to increase participation.</ExplanationTxt>
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        <ExplanationTxt>The Child and Adolescent Community Health Needs Assessment CHNA implementation plan was developed using a deliberative and inclusive internal process that included qualitative and quantitative data and was grounded in both operational considerations and the existing unique assets Boys Town National Research Hospital has already developed to address these priorities. The CHNA identified priority health issues to be addressed. Boys Town National Research Hospital and Clinics has chosen to address three issues. Mental Health Objective A Increase access to mental health services. BTNRH recruited an additional child and adolescent psychiatrist. Telepsychiatry was expanded communities such as Albion, Alliance, Lexington, McCook, Sidney, Tecumseh, Valentine, Wahoo, and Wayne. Objective B Assist patients in accessing mental health resources. Objective C Provide opportunities for mental health education and resources to employees, patients, and the public. BTNRH is planning a Mental Health national summit for April of 2025 that was announced at the American Psychological Association Conference in August of 2024. BTNRH provided resources to pediatricians on topics such as ADHD, autism spectrum disorder, and a series on psychiatry myths. Nutritional, Physical Activity and Weight Management Objective A Promote healthy eating and physical activity for patients and the community. BTNRH offered lactation counseling and had a six video series on breastfeeding basics. BTNRH will participate in Cerebral Palsy Day Carnival hosted by our Institute for Human Neuroscience. BTNRH participated in KETVs Taking Care Together by filming Grocery Store Green Flags. Topics included produce picking tips, hydration habits, snack swaps, heart healthy nutrition, overcoming mental barriers to build healthy habits. Boys Town Pediatrics sponsored Power Up exhibit at the Omaha Childrens Museum which provided education pieces on activity and nutrition. Objective B Support and expand services of SPARK clinic at east campus. BTNRH continued with steady bariatric cases and increased medical weight management options with newer weight loss drugs and referring patients to speech language pathologists who specialize in feeding therapy. BTRNH held a summer camp on June 13 and June 14 with healthy eating activities. Parenting Education and Family Support Objective A Expand Boys Town parenting resources and support services. BTNRH implemented Artera platform with location specific information and real time confirmation and cancelations, direct scheduling through a portal and contact center for primary care scheduling. BTNRH implemented the CARES program to improve the patient experience for the hospital and is working on rolling this out to the clinics. BTNRH created a series of printed menus with emotional safety tactics for parents and patients to choose from broken down by age and procedure. These menus are in use in Boys Town clinics through the child life team. This inspired a social media education series on managing fear of needles for children. BTNRH also increased the child life support in clinics including the ability to schedule child life to assist with appointments. Objective B Promote Boys Town parenting education and resources to parents and the public. BTNRH had a virtual Newborn Expo in April that includes some on site options. In the fall this event will be Newborn Week and will include five virtual presentations throughout the week and an in person skills workshop to essential skills such as infant CPR. Boys Town Pediatrics also sponsored the Power Up exhibit at the Omaha Childrens Museum that had education pieces on healthy relationships. BTNRH posted videos over summer health tips, praise ratio, ADHD, and caring for illness.</ExplanationTxt>
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          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7205 West Center Road</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68124</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Physician Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Lakeside Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>16929 Frances Street Suite 102</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68130</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Physician Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Harrison Street Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>6715 South 180th Street</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68135</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Physician Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Council Bluffs Specialty</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>320 McKenzie Avenue Suite 202</AddressLine1Txt>
            <CityNm>Council Bluffs</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>51503</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Physician Clinic Hearing Diagnostic Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Boys Town Psychiatry Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>14092 Boys Town Hospital Road</AddressLine1Txt>
            <CityNm>Boys Town</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68010</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Physician Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Lied Learning &amp; Technology Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>425 N 30th Street</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68131</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Hearing Diagnostic Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Lincoln Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>575 South 70th Street Suite 435</AddressLine1Txt>
            <CityNm>Lincoln</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68510</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Physician Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Maple Street Pediatrics</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>3838 North 167th Court</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68116</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Physician Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Center for Human Performance Optimization</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>14098 Mother Teresa Lane</AddressLine1Txt>
            <CityNm>Boys Town</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68010</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Physician Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3c</FormAndLineReferenceDesc>
        <ExplanationTxt>Boys Town National Research Hospital uses Federal Poverty Guidelines in determining free or discounted care. The patients income is the primary factor used in determining free or discounted care. However, the patients assets and/or liabilities are also reviewed on an individual basis and taken into consideration under special circumstances.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>N/A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Cost to charge ratio was used to calculate the amounts in this section. The methodology used to calculate the cost to charge ratio is the same step down method used in the Medicare Cost report further refined to define costs for the Subsidized health services and Research portions of this section.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital works closely with numerous organizations in the community to promote healthy lifestyles, including the Latino and African American community groups. The hospital conducts an annual health fair as well as participates in corporate and school health fairs, parenting classes, hearing screenings, infant car seat checks and seminars and workshops for hard of hearing and visually impaired children and their families.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Used cost to charge ratio. Only patient liability after all discounts or contractual adjustments are written off to bad debt expense. Any payments or recoveries after the write off are offset against bad debt.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Used cost to charge ratio to determine amount of bad debt that would have actually qualified as charity care but did not due to lack of information. The organization used information obtained from their outside collection agency to estimate the amount.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>In 2018, Boys Town adopted ASU No. 2014-09 Topic 606. The adoption of ASU No. 2014-09 results in no footnote disclosures related to bad debt.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Used cost to charge ratio. This organizations Medicare shortfall should not be considered a Community Benefit.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>If it is known that a patient qualifies for financial assistance the hospital would write off from 25 - 100 of their patient balance depending on their income and family size. For patients who only have a partial write-off, the hospital would follow the same collections policies on their remaining balance that are used for all other types of patients. This policy is communicated to all outside collection agencies utilized by Boys Town National Research Hospital for adherence to the policy content and financial assistance guidelines.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>In part, Boys Town National Research Hospital assesses the healthcare needs of the community by conducting a Child and Adolescent Community Health Needs Assessment with Childrens Hospital and Medical Center to help determine the health status, behaviors and needs of children in the Omaha metropolitan area. Assessment is also obtained through requests from community organizations and community residents and evaluation of the current medical landscape of services in the area. Boys Town Hospital participates in events such as corporate health fairs, minority health fairs, hearing screenings and developmental resource fairs and attends chamber meetings, nonprofit organization meetings and other community group meetings. The hospital also offers community and parenting classes, family focused recreation events such as Cerebral Palsy Day Carnival and Beeping Egg Hunt, infant car seat checks and seminars and workshops for educators, professionals and parents working with children who are deaf and hard of hearing, have speech-language concerns or other related communication disorders.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Boys Town Hospital educates patients on financial assistance eligibility and how to obtain financial assistance through brochures at each patient check in area, front desk mentions upon hospital admissions and information placed on healthcare statements. Information is also available on the website. If appliable, prior to being considered for financial assistance, the patient/family must cooperate with the provider to furnish information and documentation to apply for other existing financial resources that may be available to pay for the patients health care.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Boys Town National Research Hospital serves an eight-county Greater Omaha Metropolitan area with an estimated population of approximately 967,000 in 2021 and an additional 1.3 million who live within a 50-mile radius of Omaha US Census, July 2021 and World Population Review 2021. The two highest populated counties in the Greater Omaha area are Douglas County, population 584,526 with 25 of the population under the age of 18 years, and Sarpy County, population 194,418 with 27 under the age of 18 years US Census, July 2021. The geographic design of both counties is mainly Suburban areas with few designated urban areas. In Douglas County, the median household income is 66,600 in 2020 dollars and the percentage of residents in poverty is 9.8, both below the national average household income of 67,521 and 11.4 poverty level US Census, July 2021 and US Census 2020. Amongst Douglas County residents under the age of 65, 9.2 do not have health insurance US Census, July 2021. The number of hospitals serving the Douglas County community is 16. North and South Omaha are federally designated medically underserved areas. Currently, there are 34 federally qualified health care centers near Omaha 40 Federally Qualified Health Centers in Nebraska Carelisings. In Sarpy County, the median household income is 83,051 US Census, July 2021. The percentage of residents in poverty is 4.9, and 6.1 of residents under 65 years do not hold health insurance US Census, July 2021. Three area hospitals and two federally qualified health centers are located in the Sarpy County community. 40 Federally Qualified Health Centers in Nebraska Carelisings.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital hosts continuing education conferences and courses for physicians, nurse practitioners, nurses, researchers, audiologists and speech-language pathologists to disseminate best practices and research findings to other professionals in otolaryngology, vestibular health, hearing healthcare, speech-language therapy, neuroscience and behavioral health. The hospital provides free or subsidized services locally and nationally to hard-of-hearing children and their families through the following community building programs or activities Family Support Services - Counseling and wellness services, communication methods, educational options advisement, sign language instruction, social, emotional and educational development seminars, technology and parent child social opportunities. Educational Programs - Home based early intervention, day care consultation services, preschool education, speech language therapy, school counseling services, classroom listening technology training and consultation. Outreach - Auditory consulting school district advisement, parent and professional seminars, parent professional web-based education. The hospital is governed by the board of directors of Father Flanagans Boys Home.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>NA</ExplanationTxt>
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          <BusinessNameLine1Txt>Boys Town Central Florida Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>975 Oklahoma Street</AddressLine1Txt>
          <CityNm>Oviedo</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>32765</ZIPCd>
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          <AddressLine1Txt>300 North Broad Street Ste 106</AddressLine1Txt>
          <CityNm>New Orleans</CityNm>
          <StateAbbreviationCd>LA</StateAbbreviationCd>
          <ZIPCd>70119</ZIPCd>
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        <PurposeOfGrantTxt>Program Support</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>Boys Town Nevada Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>821 N Mojave Road</AddressLine1Txt>
          <CityNm>Las Vegas</CityNm>
          <StateAbbreviationCd>NV</StateAbbreviationCd>
          <ZIPCd>89101</ZIPCd>
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        <CashGrantAmt>5159656</CashGrantAmt>
        <PurposeOfGrantTxt>Program Support</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>Boys Town New England Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>Barzarsky Campus 58 Flanagan Road</AddressLine1Txt>
          <CityNm>Portsmouth</CityNm>
          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02871</ZIPCd>
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          <AddressLine1Txt>14100 Crawford Street</AddressLine1Txt>
          <CityNm>Boys Town</CityNm>
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          <ZIPCd>68010</ZIPCd>
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        <PurposeOfGrantTxt>Program Support</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>Boys Town North Florida Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>3555 Commonwealth Blvd</AddressLine1Txt>
          <CityNm>Tallahassee</CityNm>
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          <BusinessNameLine1Txt>Boys Town Washington DC Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>4801 Sargent Rd NE</AddressLine1Txt>
          <CityNm>Washington</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20017</ZIPCd>
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        <RecipientEIN>412220810</RecipientEIN>
        <IRCSectionDesc>501c3</IRCSectionDesc>
        <CashGrantAmt>2499702</CashGrantAmt>
        <PurposeOfGrantTxt>Program Support</PurposeOfGrantTxt>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Boys Town South Florida Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1655 Palm Beach Lakes Blvd</AddressLine1Txt>
          <CityNm>West Palm Beach</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33401</ZIPCd>
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        <PurposeOfGrantTxt>Program Support</PurposeOfGrantTxt>
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        <GrantTypeTxt>Direct Care of youth in various programs</GrantTypeTxt>
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        <ValuationMethodUsedDesc>Book</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Food, Clothing, Medical Education</NonCashAssistanceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Father Flanagans Boys Home is the sole member of nine affiliate organizations of which eight received assistance in 2023. All affiliates under an affiliation agreement with Father Flanagans Boys Home that controls the activities of the affiliated organizations. Under affiliation agreement, the subordinate organizations are required to comply with all operating and financial policies, procedures, and program service standards. Financial information is monitored on a continuous basis through a central accounting and reporting system maintained by Father Flanagans Boys Home. Each month actual and budget financial results are reviewed by management on a consolidated and individual organizational level basis. Any significant variances or fluctuations must be investigated and explained.</ExplanationTxt>
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        <PersonNm>Kelli Jo Shidler MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <PersonNm>Linden E Fornoff MD</PersonNm>
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        <PersonNm>Richard Tempero MD</PersonNm>
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        <PersonNm>Steven E Boes</PersonNm>
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        <PersonNm>Sharad Kunnath MD</PersonNm>
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        <PersonNm>Mara Paradis MD</PersonNm>
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        <PersonNm>Rodney J Kempkes</PersonNm>
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        <PersonNm>Dr Jason Bruce</PersonNm>
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        <PersonNm>Dana E Washington</PersonNm>
        <TitleTxt>Executive Vice President, General Counsel</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>32267</DeferredCompensationFlngOrgAmt>
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        <PersonNm>Barbara J Vollmer</PersonNm>
        <TitleTxt>Executive Vice President, Director of Youth Care</TitleTxt>
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        <PersonNm>Monty J Horine</PersonNm>
        <TitleTxt>Senior Vice President Corporate Secretary</TitleTxt>
        <BaseCompensationFilingOrgAmt>248135</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>24200</BonusFilingOrganizationAmount>
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        <PersonNm>James L Beckman JD</PersonNm>
        <TitleTxt>Assistant Corporate Secretary</TitleTxt>
        <BaseCompensationFilingOrgAmt>165351</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>4000</BonusFilingOrganizationAmount>
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        <FormAndLineReferenceDesc>Part I Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>Discretionary spending account and housing allowance or residence for personal use Provided to Fr. Steven Boes, the Executive Director for Father Flanagans Boys Home, Fr. Boes is required to be available 24 hours a day for any situation that may arise regarding any and all facets of providing a comprehensive continuum of care for children and families. Due to the responsibilities required for the position and considering the base salary that Fr. Boes receives, the Board of Directors granted him a discretionary spending account which is included in his taxable compensation. As a condition of employment Fr. Boes is required to live on the residential campus and is provided a personal residence in the Village of Boys Town which is not included in taxable compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The executive director has a written employment contract, but the CEO does not.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4a</FormAndLineReferenceDesc>
        <ExplanationTxt>Steven E. Boes recieved 500,000 as stipulated in the employment contract.</ExplanationTxt>
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        <ExceptionToRebateInd>true</ExceptionToRebateInd>
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        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
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        <FormAndLineReferenceDesc>Part I Line A</FormAndLineReferenceDesc>
        <ExplanationTxt>Column f Refund Hospital Authority No. 2 Douglas County and Nebraska Elementary and Secondary School Finance Authority Series 2008 Bonds, Issued 9/15/2008</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line B</FormAndLineReferenceDesc>
        <ExplanationTxt>Column f Refund Village of Boys Town Nebraska Series 2015, Issued 9/1/2015, Refund Nebraska Elementary and Secondary School Finance Authority Series 2010, Issued 11/12/2010, Construction of a high school building, building renovation and infrastructure.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part II Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Column B Bond issue proceeds does not agree to the issue in Part I Column e due to interest earnings.</ExplanationTxt>
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        <Desc>Donated Auction Items</Desc>
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      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
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        <FormAndLineReferenceDesc>Part 1 Line 9 and 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Column b The number of contributions are reported for Securities - Publicly traded and Food Inventory</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part 1 Line 25</FormAndLineReferenceDesc>
        <ExplanationTxt>Column b Number of items are auctioned items contributed.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d</FormAndLineReferenceDesc>
        <ExplanationTxt>Program Service Expenses 18,410,851, Grants and allocations 4,111, Revenue 8,287,777 ALL OTHER PROGRAMS - See Schedule O for complete description.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4a</FormAndLineReferenceDesc>
        <ExplanationTxt>Boys Town National Research Hospital BTNRH provides medical and surgical services at one hospital location and eight outpatient clinics in the Omaha, Nebraska metropolitan area. BTNRH is recognized internationally as a leader in pediatric brain development and communication disorder research and as a referral center for children with disorders of the ear, hearing and balance, cleft lip and palate, speech, and voice, as well as related disabilities. BTNRH clinical programs served over 48,100 children and adolescents in 2023 through a total of 241,400 patient visits. Boys Town Pediatrics, BTNRHs group of pediatric physicians, provides primary care and specialty pediatric medical services at seven clinic locations in the Omaha area. BTNRH employs or contracts with over 90 physicians in various subspecialties, including Allergy, Audiology, ENT, General Surgery, GI, Internal Medicine, Neurology, Ophthalmology, Outpatient Psychiatry, Physical Therapy, Rheumatology, and Speech Therapy. BTNRH also provides medically directed behavioral health services. These services include an 80-bed Psychiatric Residential Treatment Facility PRTF, which is attached to the BTNRH West Hospital. This PRTF is staffed with multidisciplinary medical and behavioral health staff. BTNRH also has a 16-bed Inpatient Psychiatric Unit IPU attached to the BTNRH West Hospital and PRTF Unit. This acute care program treats the highest-risk psychiatric youth patients. The IPU is staffed with physicians, nurses, social workers, a teacher, and psychiatric youth patients. BTNRH supports a world-class research program comprised of 48 independent laboratories that focus broadly on areas of scientific inquiry related to communication and neurobehavioral disorders. The research programs at BTNRH received over 19 million in external research funding in 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Nebraska and Iowa Services consists of the Family Home Program, Intervention and Assessment Services, In Home Family Services, Foster Family Services, Common Sense Parenting, Successful Futures, the Center for Behavioral Health, Care Coordination, and others. Boys Town operates approximately 60 Family Homes on the Home Campus, which is in the incorporated Village of Boys Town, Nebraska the Village. These homes have a total capacity of more than 350 youth. Six to eight troubled boys or girls from throughout the United States of America, with ages generally ranging from 12 to 18, live in a home with a specially trained professional married couple called Family Teachers. The couple provides treatment planning, skill development, spiritual guidance, a family style environment, and love and care, with the help of an Assistant Family Teacher. Each home is monitored, evaluated, and advised by a Program Director and other support personnel. The Family Homes are not mixed by gender but are mixed by age, ethnic, and religious backgrounds. The program is also served by three Intervention and Assessment Homes which are located on the Home Campus. The Intervention and Assessment Homes provide short term services for youth. In addition to its residential program, Boys Town also operates Foster Family Services program, In Home Family Services, and Community Support Services programs in Nebraska and Iowa. The Nebraska site operates a Center for Behavioral Health, which served over 4,000 youth in 2023 with behavioral problems on an outpatient basis, as a training center for doctoral level psychologists. The Home Campus Educational Program operates within the Boys Town Education Center. The Village schools serve residential youth at Boys Town and provide academic and vocational training skills necessary for contemporary society. All Boys Towns schools are fully accredited by the state of Nebraska and North Central Association. A full range of special education services are provided to all youth who require this type of assistance. The Boys Town Day School in the Village and the Duncan Day School in Duncan, Nebraska serve youth who cannot receive educational services in a public or alternative school setting due to behavioral problems and/or academic deficiencies. These schools meet all requirements of Level III schools under Nebraska Department of Educations Rule 51 and currently educate students from multiple school districts in Nebraska and Iowa. These schools have also served parentally placed private youth and court placed youth. Boys Town served 190 students in day school services in 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4c</FormAndLineReferenceDesc>
        <ExplanationTxt>Programs across America directly served over 10,940 youth in Nebraska/Iowa and nearly 16,400 youth at seven active affiliated sites nationwide in 2023. These affiliated sites are Boys Town Central Florida, Inc., Boys Town Louisiana, Inc., Boys Town Nevada, Inc., Boys Town New England, Inc., Boys Town North Florida, Inc., Boys Town South Florida, Inc., and Boys Town Washington, DC Inc. Programs offered throughout the nation include Intervention and Assessment Services, Family Home Program, LIFT Together with Boys Town, Foster Family Services, Common Sense Parenting, Outpatient Behavioral Health Services, Care Coordination, and others. Boys Town Youth Care programs are certified by the Council on Accreditation across all sites. Boys Town invests and emphasizes quality through staff training, evaluation, and outcomes research by having departments committed to the quality of Boys Towns programs. The Youth Care Program Quality Department provides technical training, program monitoring, consultation, evaluation and quality control/quality assurance of Boys Towns nationwide system of services. The Program Quality Department provides program monitoring, consultation, and staff and program development to all Boys Town sites across America.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d</FormAndLineReferenceDesc>
        <ExplanationTxt>Boys Town National Hotline and Public Services meets the informative and public service needs of youth, parents, teachers, and youth professionals who are involved directly or indirectly with helping youth. The Boys Town National Hotline the Hotline at 1-800-448-3000 helps hundreds of thousands of children and families throughout all 50 states each and every year. The Hotline provides toll free phone, as well as text, email, and chat crisis service for troubled children and families. The Hotline received approximately 111,000 contacts in 2023. The Hotline operates 24 hours a day, 7 days a week, with trained, skilled, professional operators. The Hotline is equipped to handle calls from people who speak a variety of languages. In an effort to reach the highest number of youth in need of assistance, through a medium more frequently used by youth, the Hotline has a website called yourlifeyourvoice.org. In 2023, the website had nearly 598,000 visits. The Hotline is the 988 Lifeline provider for the State of Nebraska. In addition to operating the Hotline, Boys Town also operates the Nebraska Family Helpline the Helpline. The Nebraska Family Helpline was conceived when Nebraska lawmakers realized families experiencing crises needed a central, knowledgeable place to go to get help or answers to their behavioral health needs. The Helpline counselors assist families in managing immediate crisis situations, make referrals, help them navigate government systems, and follow up with families to ensure they received the help they needed. The Hotline also operates the Safe 2 Help school tipline for the State of Nebraska currently covering 60 of all students in the state. The Helpline has been honored in the press and by the legislature for its effective service to Nebraska families.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>In 2023, the bylaws were amended to update language from Executive Director to Chief Executive Officer. This resulted the Executive Director becoming a voting member of the Board of Trustees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Treasurer reviewed the completed Form 990 and provided an electronic copy to the Finance and Audit Committee of the Board of Directors for their review. The members of the Finance and Audit Committee were requested to submit their comments and questions. Upon satisfactory resolution of questions, an electronic copy of the final Form 990 was provided to all directors before it was filed.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Father Flanagans Boys Home regularly and consistently monitors and enforces its conflict of interest policy through official annual affirmations, self reporting, and observation. Father Flanagans Boys Home has a separate conflict of interest policies for trustees, the executive director, and employees. Trustees must complete a conflict of interest disclosure form and report any perceived or actual conflict. Any perceived or actual conflict of interest is reviewed by the compliance department with the assistance of general counsel. If a conflict does exist, the Executive Committee, with the assistance of general counsel, shall determine an appropriate remedy which may include, without limitation, the Trustee to recuse him/herself from participating in certain deliberations and votes, removing the trustee from a committee or Board. Officers and employees of Boys Town complete a Conflict of Interest Disclosure annually, identifying all actual, apparent, and potential Conflicts of Interest. Staff are also required to report any situation involving a conflict of interest that may arise during the year to their supervisor and submitting a Conflict of Interest Disclosure for review by the compliance department. If a conflict of interest does exist, the Compliance department would work with the employee and supervisor to remedy the conflict of interest. Any perceived conflict of interest can also be reported for review through a confidential organizational ethics line at https//secure.ethicspoint.com/domain/media/en/gui/18137/index.html</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15a 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the Executive Director is determined by the Board of Trustees Compensation Committee using comparable data for similarly qualified persons in functionally comparable positions at similarly situated organizations. Documentation of the decisions made regarding the compensation have been maintained with the determination incorporated in an employment contract. The compensation of all other officers are also determined as described above, however, officers do not have employment contracts.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Father Flanagans Boys Home makes its governing documents and conflict of interest policy available to the public upon request. Articles of incorporation and bylaws can also be obtained by the public through the various Secretary of States offices. Financial Statements are available to the public upon request and on its website at www.boystown.org</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Increase in value of beneficial interest in external trust assets of 7,684,265. Increase in beneficial interest in Father Flanagans Fund for Needing Children 54,692,527. Increase in interest in affiliated organizations 3,542,309 and pension related charges 1,899,929. Decrease in present value changes of 861,123.</ExplanationTxt>
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