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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2908586</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>5565685</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>669922</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>36</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DELPHI HOSPITALIST SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2701 CULVER ROAD</AddressLine1Txt>
            <CityNm>ROCHESTER</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14622</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>STAFFING</ServicesDesc>
        <CompensationAmt>1413912</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DELPHI HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2701 CULVER ROAD</AddressLine1Txt>
            <CityNm>ROCHESTER</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14622</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>STAFFING</ServicesDesc>
        <CompensationAmt>1635271</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PICCO PULMONARY &amp; INTERNAL MEDICINE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>11 MAIN STREET</AddressLine1Txt>
            <CityNm>HORNELL</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14843</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL PHYSICIAN</ServicesDesc>
        <CompensationAmt>758745</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>JEREMY OOSTERKAMP</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3750 TRANSIT ROAD</AddressLine1Txt>
            <CityNm>ORCHARD PARK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14127</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CRNA</ServicesDesc>
        <CompensationAmt>282500</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>CORAZON HOFFMAN</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>211 HAEGELE PLACE</AddressLine1Txt>
            <CityNm>MT ROYAL</CityNm>
            <StateAbbreviationCd>NJ</StateAbbreviationCd>
            <ZIPCd>08061</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CRNA</ServicesDesc>
        <CompensationAmt>187652</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>9</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>15187</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>5717491</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>76687</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>5809365</TotalContributionsAmt>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>51301572</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>51301572</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>51301572</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>246106</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>246106</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>137979</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>48464</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>89515</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>89515</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>89515</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>19000</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>19000</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>19000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>19000</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <OtherRevenueMiscGrp>
        <Desc>STAFF LEASING</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>331992</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>331992</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAFETERIA</Desc>
        <BusinessCd>722212</BusinessCd>
        <TotalRevenueColumnAmt>238915</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>238915</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>340B CONTRACT PHARMACY</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>2242208</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>2242208</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>1827245</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1827245</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>4640360</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>62105918</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>51301572</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>4994981</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>392831</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>392831</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
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      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
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        <ProgramServicesAmt>20262128</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4144431</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>187920</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42080</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
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        <ProgramServicesAmt>2525776</ProgramServicesAmt>
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      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
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        <ManagementAndGeneralAmt>321719</ManagementAndGeneralAmt>
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      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>42729</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42729</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>126103</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>126103</ManagementAndGeneralAmt>
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      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>117235</ManagementAndGeneralAmt>
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      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
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        <ProgramServicesAmt>1400</ProgramServicesAmt>
        <ManagementAndGeneralAmt>47084</ManagementAndGeneralAmt>
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      </AdvertisingGrp>
      <OfficeExpensesGrp>
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        <ProgramServicesAmt>12105518</ProgramServicesAmt>
        <ManagementAndGeneralAmt>447880</ManagementAndGeneralAmt>
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      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>12658</TotalAmt>
        <ProgramServicesAmt>11292</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1366</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <FundraisingAmt>0</FundraisingAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>29796</TotalAmt>
        <ProgramServicesAmt>24964</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4832</ManagementAndGeneralAmt>
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      </ConferencesMeetingsGrp>
      <InterestGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11268</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
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        <FundraisingAmt>0</FundraisingAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>1550669</ProgramServicesAmt>
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      <InsuranceGrp>
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        <ManagementAndGeneralAmt>-33398</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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        <Desc>PROFESSIONAL FEES</Desc>
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        <ProgramServicesAmt>10146410</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1134120</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>PURCHASEDSERVICES</Desc>
        <TotalAmt>2995357</TotalAmt>
        <ProgramServicesAmt>1964674</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1030683</ManagementAndGeneralAmt>
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      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MAINTENANCE AND REPAIRS</Desc>
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        <ProgramServicesAmt>755326</ProgramServicesAmt>
        <ManagementAndGeneralAmt>73177</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
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        <ProgramServicesAmt>1311376</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>52284161</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8646085</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>6506941</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>119527</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>0</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>15083699</EOYAmt>
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      <ReceivablesFromOfficersEtcGrp>
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        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
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        <EOYAmt>0</EOYAmt>
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      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>1716116</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>264218</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>53820132</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>31124551</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>22695581</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>8254358</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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      <IntangibleAssetsGrp>
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        <EOYAmt>2230000</EOYAmt>
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        <EOYAmt>2626298</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>59496738</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>12020291</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>449759</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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        <EOYAmt>0</EOYAmt>
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      <EscrowAccountLiabilityGrp>
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        <EOYAmt>0</EOYAmt>
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      <LoansFromOfficersDirectorsGrp>
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        <EOYAmt>0</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>0</EOYAmt>
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      <UnsecuredNotesLoansPayableGrp>
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        <EOYAmt>0</EOYAmt>
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      <OtherLiabilitiesGrp>
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        <EOYAmt>9694969</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>22053635</BOYAmt>
        <EOYAmt>22165019</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>30133288</BOYAmt>
        <EOYAmt>33475994</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>3135998</BOYAmt>
        <EOYAmt>3855725</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
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        <EOYAmt>37331719</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>55322921</BOYAmt>
        <EOYAmt>59496738</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
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        <ExplanationTxt>For Priority Area: Prevent Chronic Disease, Focus Area Healthy Eating and Food Security. Interventions, strategies and activities will work towards increasing the redemption of farmers market coupons distributed through the WIC Program and the Office for the Aging. These will include but are not limited to developing a key stakeholders group; a work plan; increased access to the farmers markets; increase knowledge of use; preparation and preservation of fruits and vegetables; and program review using guidance workbook to expand activities over year two and three. For Priority Area: Prevent Chronic Disease, Focus Area: Preventative Care and Management. Interventions, strategies and activities will work toward increasing the number of adults with a chronic disease who have taken a course or class to learn how to manage their condition. These will include but are not limited to identifying additional agencies and their staff to be trained to facilitate the Stanford University Chronic Disease Self Management course; Ardent Solutions Inc Master Trainer offering trainings to increase the number of facilitators in Allegany County; offering a minimum of two CDSM workshop series each year and collaborating with area health care providers and their care managers to identify their patients with chronic diseases and make referrals to CDSM. For Priority Area: Promote Well Being and Prevent Mental and Substance Use Disorders. Interventions, strategies and activities will work toward decreasing the age adjusted suicide mortality rates by ten percent by 2021. These will include but are not limited to supporting and promoting the suicide prevention coalition activities; offering programming to prevent suicides including ASIST, Mental Health First Aid, Safe Talk and Talk Saves Lives, evaluating the suicide prevention program in Allegany County using RAND or a similar tool kit and developing an action plan for years two and three. For Disparity Socio Economical Income; the evidence based interventions, strategies and activities locally decreases the financial burden to the residents of Allegany County by reducing the travel and time expense to county residents.</ExplanationTxt>
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        <ExplanationTxt>https://www.urmc.rochester.edu/jones-memorial-hospital.aspx</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16c-JONES MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>https://www.urmc.rochester.edu/jones-memorial-hospital.aspx</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Worksheet 2 Ratio of Patient Care Cost to Charges calculation was used. Due to the adoption of accounting pronouncement ASC 606, current year price concessions are treated as a contra-revenue item on the statement of revenue.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7g</FormAndLineReferenceDesc>
        <ExplanationTxt>Jones Memorial Hospital operates a Diabetic Clinic as a service to the public due to the high need for it in Allegany County.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section A, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Patient Accounts Receivable are due 30 days after the date of discharge. Receivables past due more than 120 days are considered delinquent. Delinquent receivables are generally written off based on individual credit evaluation and specific circumstances of the patient and other third party payers. Bad Debt Expense is calculated by deducting bad debt adjustments and receipts from transfers to the collection agency. In addition, an analysis is done monthly based on self pay aging and assessed reserve percentages in order to determine reasonableness. Further information is on page 12 of the attached audited financial statements.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section B, Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount on Line 6 is calculated from Worksheet E Parts A and B on the cost report. The full loss should be considered a community benefit.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section C, Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>Patients who qualify for financial assistance receive a discount from a sliding fee schedule based on the Federal Poverty Guidelines. Flexible payment plans are incorporated as appropriate.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital uses several methods to assess the healthcare needs of those in the service area. Public survey includes some demographic information and a ratings system for 49 items identified as health needs. The public was notified of the survey process and encouraged to participate through paid advertising in the Wellsville Daily Reporter and Hornell Evening Tribune, press releases to local news agencies, invitations on the hospital website home page, distribution of paper surveys through the JMH medical practice sites (six in total throughout Allegany County) and through email distribution of the survey to agency list serves in the region. The survey was also distributed via Survey Monkey, an online survey to allow recipients to receive and respond via email. The most recent survey was May 5, 2023 - June 30, 2023. This survey is completed every 2-3 years.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Our patient statements provide a notice informing patients about our Financial Assistance Program. We have financial counselors that contact our self pay population and inform them of our program. They send letters for those they are unable to reach by telephone. We have signage throughout our campus indicating we have a financial assistance program with the contact information. Each self pay inpatient is seen and educated about our process for applying for financial assistance.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>The Hospital service area is primarily Allegany and Steuben Counties, while 80 percent of the inpatient and outpatient visits originate from Wellsville, Bolivar, Andover, Belmont, Scio, Friendship, Belfast, Angelica and Whitesville for the purposes of community health need and collaboration efforts. Jones Memorial Hospital views the greater Allegany County region as the service area. Jones Memorial Hospital is the only acute care hospital in Allegany County with HPSA Designation.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Jones Memorial Hospital promotes community wellness in many ways. Several activities were planned however, due to COVID restrictions many were cancelled. The following activities were completed: 1. Blood pressure cuffs were distributed to our providers for patients identified with hypertension. They were given to the patient and instructed to monitor their blood pressure to assess whether adjustments to medications or diet were necessary. 2. Pediatric patients received a book to encourage reading. 3. Jones Memorial Hospital was a corporate sponsor for a RAM (Rural Area Medical) Clinic. Overall, 316 individual patients were seen, resulting in $103,000 of free medical care. Several staff participated in the event. Stroke and health information was displayed. 4. Blood pressure machine support at the local YMCA and in the Outpatient Lab area at Jones Memorial Hospital. 5. Participation in the community meetings for development of a Local Waterfront Revitalization Program. 6. County-wide wellness meetings to support the Community Service Plan. 7. Covid employee and community vaccinations. 8. Covid testing programs.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital is affliated with the University of Rochester Medical Center (URMC). Together with the Hospital, URMC and its other health care affliates provide comprehensive healthcare services in New York State. This affliation provides enhanced care to residents of the Hospital's service area through access to specialists and specialty services. The University of Rochester Medical Center is an integrated academic health center that comprises the School of Medicine and Dentistry, including its Faculty Practice (University of Rochester Medical Faculty Group); Strong Memorial Hospital; Highland Hospital; Golisano Children's Hospital; James P. Wilmot Cancer Center; Strong West; School of Nursing; Eastman Institute for Oral Health; Visiting Nurse Service; Highlands at Pittsford; The Highlands Living Center, Inc., Highlands at Brighton, FF Thompson Health System, Inc., Jones Memorial Hospital, Noyes Health, St. James Hospital and Accountable Health Partners, LLC. UR Medical Center and the Affliated Health Care entities have embraced a comprehensive approach to community health, which employs the multidisciplinary skills found in an academic medical center to both provide important community services and conduct community-based research. These activities help inform policymakers and the community about local health challenges, evaluate the effectiveness of interventions, and serve as a foundation for evidence-based practices to improve health and overall quality of life.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Decisions such as amendment of the Certificate of Incorporation and Bylaws and approval of extraordinary corporate actions such as merger or dissolution are subject to the approval of the University of Rochester.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The 990 was presented to the Board of Directors prior to filing. The 990 is prepared by the Accounting Department and reviewed by the VP of Finance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Annually, the Hospital requires all Board Members, Senior Managers and Department Managers to complete the Conflict of Interest statement to identify actual and potential conflicts. The statements are reviewed by the Hospital's Compliance Officer for any potential conflicts. If a conflict is identified, the individual with the conflict will not be allowed to participate in any discussion or decision in any area of conflict identified.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO's salary is set for a specific contract period by the Board of Directors and includes an escalation clause for increases during the contract period. The process includes a review of comparable data for the market area and the complete contract is approved by the Board of Directors. Compensation of other top management officials and key employees is done through a wage analysis performed by the Human Resources Director. The analysis compares current wage to market data. The CEO reviews the analysis.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital's Form 990 is available upon request. The Hospital's governing documents, conflict of interest policy and audited financial statements are not routinely made available to the public. The hospital publishes an annual financial and statistical report in the local newspaper each spring. It also has these documents available for in person review or within 30 days of a written request from the general public. Copies of these documents are stored in the Administrative Office of the Hospital for this purpose</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in unrealized gain/losses on investments = -917,919, Pension liability adjustment = 1,460,986, transfers from University of Rochester = 1,623,967, change in value of beneficial interest in perpetual trust = -313,581 and change in value of beneficial interest in foundation = 1,033,308.</ExplanationTxt>
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        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>URM HOME CARE CERTIFIED SRVCS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>LIVINGSTON HEALTH CARE SYSTEM INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 CLARA BARTON STREET</AddressLine1Txt>
          <CityNm>DANSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14427</ZIPCd>
        </USAddress>
        <EIN>161455240</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A, 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UNIV OF ROCH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NICHOLAS H NOYES MEMORIAL HOSPITAL INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 CLARA BARTON STREET</AddressLine1Txt>
          <CityNm>DANSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14427</ZIPCd>
        </USAddress>
        <EIN>160743979</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LHCS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>RED JACKET CENTER INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 CLARA BARTON STREET</AddressLine1Txt>
          <CityNm>DANSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14427</ZIPCd>
        </USAddress>
        <EIN>161037658</EIN>
        <PrimaryActivitiesTxt>MEDICAL BLDG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A, 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LHCS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 CLARA BARTON STREET</AddressLine1Txt>
          <CityNm>DANSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14427</ZIPCd>
        </USAddress>
        <EIN>161584778</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LHCS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>JONES MEMORIAL HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>191 NORTH MAIN STREET</AddressLine1Txt>
          <CityNm>WELLSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14895</ZIPCd>
        </USAddress>
        <EIN>473763374</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>JONES HOSP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>JONES MEDICAL SERVICES PC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>191 NORTH MAIN STREET</AddressLine1Txt>
          <CityNm>WELLSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14895</ZIPCd>
        </USAddress>
        <EIN>465210222</EIN>
        <PrimaryActivitiesTxt>MEDICAL CLINIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>JONES HOSP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST JAMES HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>7329 SENECA ROAD NORTH</AddressLine1Txt>
          <CityNm>HORNELL</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14843</ZIPCd>
        </USAddress>
        <EIN>160743310</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UNIV OF ROCH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST JAMES HOSPITAL FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>7329 SENECA ROAD NORTH</AddressLine1Txt>
          <CityNm>HORNELL</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14843</ZIPCd>
        </USAddress>
        <EIN>161486437</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ST JAMES HOSP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UR MEDICINE HOME CARE COMMUNITY SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2180 EMPIRE BOULEVARD</AddressLine1Txt>
          <CityNm>WEBSTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14580</ZIPCd>
        </USAddress>
        <EIN>825091873</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>URMHC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UR MEDICINE HOME CARE FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2180 EMPIRE BOULEVARD</AddressLine1Txt>
          <CityNm>WEBSTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14580</ZIPCd>
        </USAddress>
        <EIN>831912967</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 C (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A, 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>URMHC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EXCELL INNOVATE NY FUND LP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>343 STATE STREET KODAK TOWER 2ND</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14650</ZIPCd>
        </USAddress>
        <EIN>462405519</EIN>
        <PrimaryActivitiesTxt>INVESTMENT FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETV INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EXCELL MINORITY AND WOMEN OWNED BUSINESS INVESTMENT FUND LP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>343 STATE STREET KODAK TOWER 2ND</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14650</ZIPCd>
        </USAddress>
        <EIN>810723223</EIN>
        <PrimaryActivitiesTxt>INVESTMENT FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETV INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EXCELL PARTNERS INNOVATIVE TC FUND LP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>343 STATE STREET KODAK TOWER 2ND</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14650</ZIPCd>
        </USAddress>
        <EIN>810711015</EIN>
        <PrimaryActivitiesTxt>INVESTMENT FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETV INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>FINGER LAKES VENTURE FUND LP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>343 STATE STREET KODAK TOWER 2ND</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14650</ZIPCd>
        </USAddress>
        <EIN>833941257</EIN>
        <PrimaryActivitiesTxt>INVESTMENT FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETV INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDICAL ADMINISTRATIVE ASSOCIATES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>777 SOUTH CLINTON AVENUE</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14620</ZIPCd>
        </USAddress>
        <EIN>161354319</EIN>
        <PrimaryActivitiesTxt>RETAIL PHARMACY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HIGHLD HOSP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>UREQUITY HOLDINGS INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 OFFICE PARK WAY</AddressLine1Txt>
          <CityNm>PITTSFORD</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14534</ZIPCd>
        </USAddress>
        <EIN>273040889</EIN>
        <PrimaryActivitiesTxt>HOLDING CO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DE</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UNIV OF ROCH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>FFTH PROPERTIES AND SERVICES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>350 PARRISH STREET</AddressLine1Txt>
          <CityNm>CANANDAIGUA</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14424</ZIPCd>
        </USAddress>
        <EIN>161286518</EIN>
        <PrimaryActivitiesTxt>HOLDING CO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>THS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EXCELL TECHNOLOGY VENTURES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>343 STATE STREET KODAK TOWER 2ND</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14650</ZIPCd>
        </USAddress>
        <EIN>800909149</EIN>
        <PrimaryActivitiesTxt>BIOTECH INCUBATOR</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ROCH BIOVENTURE</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ACCOUNTABLE HEALTH PARTNERS LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>135 CORPORATE WOODS STE 320</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14623</ZIPCd>
        </USAddress>
        <EIN>300787967</EIN>
        <PrimaryActivitiesTxt>ACCT CARE NETWORK</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UNIV OF ROCH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ACCOUNTABLE HEALTH PARTNERS IPA LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>135 CORPORATE WOODS STE 320</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14623</ZIPCd>
        </USAddress>
        <EIN>371746016</EIN>
        <PrimaryActivitiesTxt>INDEP PRACTICE ASSOC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>AHP LLC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>AHP INSURANCE COMPANY</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>76 ST PAUL STREET SUITE 500</AddressLine1Txt>
          <CityNm>BURLINGTON</CityNm>
          <StateAbbreviationCd>VT</StateAbbreviationCd>
          <ZIPCd>05401</ZIPCd>
        </USAddress>
        <EIN>814644839</EIN>
        <PrimaryActivitiesTxt>CAPTIVE INSURANCE CO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>VT</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>AHP LLC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>LUMINATE VENTURE CHALLENGE CORP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>260 EAST MAIN STREET SUITE 6000</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14604</ZIPCd>
        </USAddress>
        <EIN>823954131</EIN>
        <PrimaryActivitiesTxt>BUSINESS INCU</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NEXTCORPS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HORNELL MEDICAL VILLAGE LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>7100 ROUTE 70A</AddressLine1Txt>
          <CityNm>HORNELL</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14843</ZIPCd>
        </USAddress>
        <EIN>611886763</EIN>
        <PrimaryActivitiesTxt>HOLD REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ST JAMES HOSP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>JONES MEDICAL SERVICES PC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>q</TransactionTypeTxt>
        <InvolvedAmt>895000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Invoices and timesheets</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
    <ReasonableCauseExplanation documentId="R000009" softwareId="21013178" softwareVersionNum="v1.00">
      <ExplanationTxt>Filed IRS Form 8868.</ExplanationTxt>
    </ReasonableCauseExplanation>
  </ReturnData>
</Return>