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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DENISE CLAYTON</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>YUBELKIS FERNANDEZ</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL JOHNS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSELYNNE JONES CELESTINE MED MS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VERONICA HILL-MILBOURNE</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8346</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHAWNA RUSSELL-YOUNG</PersonNm>
        <TitleTxt>CHIEF COMPLIANCE &amp; PRIVACY OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>142953</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THERESA J BAUGH</PersonNm>
        <TitleTxt>CHIEF OPERATIONS OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>217220</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR AQIYLA MUHAMMAD</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>271753</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7320</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID DEMILIO</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>243321</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5891</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFFREY DUNBAR MD</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>206238</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6187</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AKILAH BATES</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>201663</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6050</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MYRON LSEWELL</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>171167</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MYRA UNDERWOOD-RUTLAND</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromOrgAmt>125053</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANITA S GILL</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>122658</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3680</OtherCompensationAmt>
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      <TotalReportableCompFromOrgAmt>2076183</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>41226</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>13</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ATHENAHEALTH INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>311 ARSENAL STREET</AddressLine1Txt>
            <CityNm>WATERTOWN</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02472</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ALLIED UNIVERSAL</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <CityNm>CONSHOHOCKEN</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19428</ZIPCd>
          </USAddress>
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      <CntrctRcvdGreaterThan100KCnt>15</CntrctRcvdGreaterThan100KCnt>
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      <TotalContributionsAmt>5669515</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>13628465</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13628465</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>PHARMACY REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>6143387</RelatedOrExemptFuncIncomeAmt>
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      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2900</TotalRevenueColumnAmt>
        <ExclusionAmt>2900</ExclusionAmt>
      </InvestmentIncomeGrp>
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        <Desc>REIMBURSMENTS</Desc>
        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>72032</ExclusionAmt>
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      <OtherRevenueMiscGrp>
        <Desc>MEDICAL RECORDS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>8409</TotalRevenueColumnAmt>
        <ExclusionAmt>8409</ExclusionAmt>
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      <OtherRevenueMiscGrp>
        <Desc>PHARMACY RENTS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>3300</TotalRevenueColumnAmt>
        <ExclusionAmt>3300</ExclusionAmt>
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      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>2651</TotalRevenueColumnAmt>
        <ExclusionAmt>2651</ExclusionAmt>
      </MiscellaneousRevenueGrp>
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      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>25530659</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>19771852</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>89292</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>497234</ProgramServicesAmt>
        <ManagementAndGeneralAmt>585794</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>5041706</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2544924</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>43851</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24687</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1257902</TotalAmt>
        <ProgramServicesAmt>812783</ProgramServicesAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>602724</TotalAmt>
        <ProgramServicesAmt>385627</ProgramServicesAmt>
        <ManagementAndGeneralAmt>217097</ManagementAndGeneralAmt>
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      <FeesForServicesLegalGrp>
        <TotalAmt>208074</TotalAmt>
        <ManagementAndGeneralAmt>208074</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>101768</TotalAmt>
        <ManagementAndGeneralAmt>101768</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
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        <ProgramServicesAmt>1491943</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1125500</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>2958</TotalAmt>
        <ProgramServicesAmt>1686</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1272</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>8395</ProgramServicesAmt>
        <ManagementAndGeneralAmt>170741</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
        <TotalAmt>371384</TotalAmt>
        <ProgramServicesAmt>211689</ProgramServicesAmt>
        <ManagementAndGeneralAmt>159695</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>607011</TotalAmt>
        <ProgramServicesAmt>345996</ProgramServicesAmt>
        <ManagementAndGeneralAmt>261015</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>44797</TotalAmt>
        <ProgramServicesAmt>25534</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19263</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>5763</TotalAmt>
        <ProgramServicesAmt>3285</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2478</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>332082</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8187</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>473712</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11679</ManagementAndGeneralAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>154474</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3808</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES &amp; DRUG</Desc>
        <TotalAmt>2702355</TotalAmt>
        <ProgramServicesAmt>2702355</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>665009</TotalAmt>
        <ProgramServicesAmt>665009</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>54364</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41011</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>16682</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12585</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>1259</TotalAmt>
        <ProgramServicesAmt>718</ProgramServicesAmt>
        <ManagementAndGeneralAmt>541</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>19214363</TotalAmt>
        <ProgramServicesAmt>13269125</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5945238</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>3495067</BOYAmt>
        <EOYAmt>6569789</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
        <BOYAmt>4648284</BOYAmt>
        <EOYAmt>4220760</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>2281430</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>14778</BOYAmt>
        <EOYAmt>366465</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>134558</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>14090437</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>10337584</EOYAmt>
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      <OtherAssetsTotalGrp>
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        <EOYAmt>1543494</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
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        <EOYAmt>25454080</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>1657947</EOYAmt>
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        <EOYAmt>5962496</EOYAmt>
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      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>1340100</BOYAmt>
      </UnsecuredNotesLoansPayableGrp>
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        <EOYAmt>73917</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>7772277</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
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        <EOYAmt>17681803</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>11472434</BOYAmt>
        <EOYAmt>17681803</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>21394415</BOYAmt>
        <EOYAmt>25454080</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>6316296</ReconcilationRevenueExpnssAmt>
      <PriorPeriodAdjustmentsAmt>-201814</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>94887</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>3265098</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3743406</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3898958</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4784442</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5669515</CurrentTaxYearAmt>
        <TotalAmt>21361419</TotalAmt>
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      <GrossReceiptsAdmissionsGrp>
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        <CurrentTaxYearMinus3YearsAmt>8692410</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>13082807</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>17308326</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>19771852</CurrentTaxYearAmt>
        <TotalAmt>68104472</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
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        <CurrentTaxYearMinus3YearsAmt>12435816</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16981765</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>22092768</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>25441367</CurrentTaxYearAmt>
        <TotalAmt>89465891</TotalAmt>
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        <CurrentTaxYearMinus3YearsAmt>3650</CurrentTaxYearMinus3YearsAmt>
        <TotalAmt>3650</TotalAmt>
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      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus3YearsAmt>3650</CurrentTaxYearMinus3YearsAmt>
        <TotalAmt>3650</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>89462241</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>101637</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>70805</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10304</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3830</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2900</CurrentTaxYearAmt>
        <TotalAmt>189476</TotalAmt>
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      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>101637</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>70805</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10304</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3830</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2900</CurrentTaxYearAmt>
        <TotalAmt>189476</TotalAmt>
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      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>79638</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus1YearAmt>69017</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>86392</CurrentTaxYearAmt>
        <TotalAmt>235047</TotalAmt>
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      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>12695450</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12506621</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16992069</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>22165615</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>25530659</CurrentTaxYearAmt>
        <TotalAmt>89890414</TotalAmt>
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      <PublicSupportCY509Pct>0.99520</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99380</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00210</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00380</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME - 2017 AMOUNT: $ 79,638. 2021 AMOUNT: $ 2,651. MEDICAL RECORDS - 2020 AMOUNT: $ 7,517. 2021 AMOUNT: $ 8,409. REIMBURSEMENTS - 2020 AMOUNT: $ 61,500. 2021 AMOUNT: $ 72,032. PHARMACY RENTS - 2021 AMOUNT: $ 3,300.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>644000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>644000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>9033531</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>694869</DepreciationAmt>
        <BookValueAmt>8338662</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>279307</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>167544</DepreciationAmt>
        <BookValueAmt>111763</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>4133599</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2890440</DepreciationAmt>
        <BookValueAmt>1243159</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>10337584</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>DEPOSITS</Desc>
        <BookValueAmt>56494</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>DUE FROM THIRD PARTY PAYORS</Desc>
        <BookValueAmt>1487000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>1543494</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>INTEREST RATE SWAP</Desc>
        <Amt>73917</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>73917</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>24960537</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>-570122</OtherRevenueAmt>
      <RevenueNotReportedAmt>-570122</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>25530659</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>25530659</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>18549354</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>18549354</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>665009</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>665009</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>19214363</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE ORGANIZATION TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY OR ASSET IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICES (IRS). THE ORGANIZATION HAS CONCLUDED THAT AS OF JUNE 30, 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR ASSET OR DISCLOSURE IN THE FINANCIAL STATEMENTS. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2019, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN VALUE OF INTEREST RATE SWAP 94,887. BAD DEBT NET WITH REVENUE -665,009.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT NET WITH REVENUE 665,009.</ExplanationTxt>
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    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
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        <PersonNm>VERONICA HILL-MILBOURNE</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>278216</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>95941</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8346</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>382503</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR AQIYLA MUHAMMAD</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>244007</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>27746</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>279073</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID DEMILIO</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>196373</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>46948</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5891</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>249212</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THERESA J BAUGH</PersonNm>
        <TitleTxt>CHIEF OPERATIONS OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>185657</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>217220</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JEFFREY DUNBAR MD</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <BaseCompensationFilingOrgAmt>206238</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6187</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>212425</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AKILAH BATES</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <BaseCompensationFilingOrgAmt>201663</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6050</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>207713</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MYRON LSEWELL</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <BaseCompensationFilingOrgAmt>171167</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>171167</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE TEAM DECIDES ON INCENTIVE PROGRAMS AND THE BOARD APPROVES BONUSES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE 990 IS REVIEWED WITH THE CFO AND CEO. THE FINAL 990 IS PROVIDED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE CORPORATION'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE CORPORATION. ANY DIRECTOR, OFFICER, MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, EMPLOYEE OR AGENT WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST IS AN INTERESTED PERSON. AN INTERESTED PERSON HAS A DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST. THEY MUST DISCLOSE THE EXISTENCE OF HIS/HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED AS POTENTIAL SOURCES OF CONFLICT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT AN INDIVIDUAL HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE BOARD SHALL INFORM THE INDIVIDUAL OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER OPPORTUNITY TO EXPLAIN. IF THE BOARD DETERMINES THAT THE INDIVIDUAL HAS IN FACT FAILED TO DISCLOSE, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION DETERMINATION: THERE IS A SALARY COMPENSATION PLAN THAT IS IN PLACE THAT IS PERIODICALLY REVIEWED AND COMPARED AGAINST COMPARABLE SALARY DATA AT THE REGIONAL AND LOCAL LEVELS BY AN OUTSIDE CONSULTANT. THE PROCESS: MARKET PRICING - THE CONSULTANT USES JOB DESCRIPTIONS TO MATCH JOBS TO THE EXTERNAL MARKET. THE CONSULTANT USES A MIX OF NON-PROFIT AND FOR-PROFIT DATA FROM REGIONAL AND LOCAL SALARY SURVEYS AS WELL AS HEALTH CARE DATA. THE CONSULTANT SEARCHES FOR MARKET DATA THAT MATCHES THE ORGANIZATION'S POSITIONS AND THEN ABSTRACTS SALARY DATA FROM THE 25TH, 50TH AND 75TH PERCENTILE OF THE MARKET FOR EACH POSITION. THIS DATA IS THEN USED FOR SALARY STRUCTURES. A COMPARISON IS MADE OF THE MEDIAN MARKET VALUES TO THE MIDPOINT OF THE CURRENT PAY STRUCTURES, WHICH INDICATES WHERE THE POSITION FALLS WITHIN THE MARKET. CEO, CFO, DIRECTORS, AND KEY EMPLOYEE COMPENSATION WAS LAST REVIEWED AND DOCUMENTED BY THE BOARD IN JULY 2020.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENT DISCLOSURE: THE AGENCY MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,443,987. MANAGEMENT AND GENERAL EXPENSES 1,089,323. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,533,310. LAB SERVICES: PROGRAM SERVICE EXPENSES 47,956. MANAGEMENT AND GENERAL EXPENSES 36,177. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,133.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN VALUE OF INTEREST RATE SWAP 94,887.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPECTRUM INVESTMENT FUND LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5201 HAVERFORD AVE</AddressLine1Txt>
          <CityNm>PHILADELPHIA</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>19139</ZIPCd>
        </USAddress>
        <EIN>453459252</EIN>
        <PrimaryActivitiesTxt>INVESTMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <TotalIncomeAmt>0</TotalIncomeAmt>
        <EndOfYearAssetsAmt>0</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SPECTRUM HEALTH SERVICES INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SHS COMMUNITY HEALTH INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5201 HAVERFORD AVE</AddressLine1Txt>
          <CityNm>PHILADELPHIA</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>19139</ZIPCd>
        </USAddress>
        <EIN>300713501</EIN>
        <PrimaryActivitiesTxt>HOLDING CO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(2)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>N/A</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</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>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
