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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jim Walton</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cathy Bryan</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Julie Clark</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Catherine Corrigan</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Benjamin Isgur</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Kirsten Kerrigan</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Louise Marsh</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mathew Craft</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Effie Dennison</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kathleen Gibson</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kelby Hagar</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Allison Draper Lolley</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Carolyn Rathjen</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Chris Simmons</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Andres Villareal</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>1</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cici Weinmann</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kevin Eden</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Eugenia King</PersonNm>
        <TitleTxt>Board Chair Elect</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jordan Brainerd</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mary Frances Bellman</PersonNm>
        <TitleTxt>Chairman</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1098328</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>233976</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>145179</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>8</IndivRcvdGreaterThan100KCnt>
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      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Neeta Nayak MD</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4016 Nicole Drive</AddressLine1Txt>
            <CityNm>Richardson</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75082</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Mary Anne Chacko MD</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4716 Holly Tree Dive</AddressLine1Txt>
            <CityNm>Dallas</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75287</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician</ServicesDesc>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Kristina Hernandez MD</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>600 Lasater Court</AddressLine1Txt>
            <CityNm>Dallas</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>76248</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician</ServicesDesc>
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      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>3</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>2244476</GovernmentGrantsAmt>
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      <TotalContributionsAmt>9079618</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Medicare</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>17936069</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>17936069</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Medicaid</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>1543458</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1543458</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Private Pay/Insurance</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>600833</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>600833</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Title III,XIX, &amp; XX</Desc>
        <BusinessCd>624210</BusinessCd>
        <TotalRevenueColumnAmt>5127372</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5127372</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
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        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>25207732</TotalProgramServiceRevenueAmt>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>1641</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1641</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>1641</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>25209373</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>244029</ProgramServicesAmt>
        <ManagementAndGeneralAmt>854299</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>11738404</ProgramServicesAmt>
        <ManagementAndGeneralAmt>734963</ManagementAndGeneralAmt>
        <FundraisingAmt>20000</FundraisingAmt>
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        <ProgramServicesAmt>320273</ProgramServicesAmt>
        <ManagementAndGeneralAmt>170242</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1982180</ProgramServicesAmt>
        <ManagementAndGeneralAmt>199806</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>969694</TotalAmt>
        <ProgramServicesAmt>873433</ProgramServicesAmt>
        <ManagementAndGeneralAmt>94276</ManagementAndGeneralAmt>
        <FundraisingAmt>1985</FundraisingAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>154681</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
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        <TotalAmt>797649</TotalAmt>
        <ProgramServicesAmt>789900</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7749</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <AdvertisingGrp>
        <TotalAmt>356151</TotalAmt>
        <ProgramServicesAmt>251364</ProgramServicesAmt>
        <ManagementAndGeneralAmt>92287</ManagementAndGeneralAmt>
        <FundraisingAmt>12500</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>810484</TotalAmt>
        <ProgramServicesAmt>712596</ProgramServicesAmt>
        <ManagementAndGeneralAmt>97888</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>792064</TotalAmt>
        <ProgramServicesAmt>762722</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18342</ManagementAndGeneralAmt>
        <FundraisingAmt>11000</FundraisingAmt>
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      <OccupancyGrp>
        <TotalAmt>1043814</TotalAmt>
        <ProgramServicesAmt>846806</ProgramServicesAmt>
        <ManagementAndGeneralAmt>197008</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>779523</TotalAmt>
        <ProgramServicesAmt>779082</ProgramServicesAmt>
        <ManagementAndGeneralAmt>441</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>113874</TotalAmt>
        <ProgramServicesAmt>108601</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5273</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1108109</TotalAmt>
        <ProgramServicesAmt>1072715</ProgramServicesAmt>
        <ManagementAndGeneralAmt>35394</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>241113</TotalAmt>
        <ProgramServicesAmt>195416</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45697</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Patient DME</Desc>
        <TotalAmt>2687110</TotalAmt>
        <ProgramServicesAmt>2657188</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29922</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Patient Supplies &amp; Drugs</Desc>
        <TotalAmt>1460850</TotalAmt>
        <ProgramServicesAmt>1460639</ProgramServicesAmt>
        <ManagementAndGeneralAmt>211</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Food</Desc>
        <TotalAmt>5565989</TotalAmt>
        <ProgramServicesAmt>5565989</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Membership Dues</Desc>
        <TotalAmt>53413</TotalAmt>
        <ProgramServicesAmt>48686</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4727</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>174764</TotalAmt>
        <ProgramServicesAmt>102665</ProgramServicesAmt>
        <ManagementAndGeneralAmt>72099</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>33373478</TotalAmt>
        <ProgramServicesAmt>30512688</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2815305</ManagementAndGeneralAmt>
        <FundraisingAmt>45485</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>5232594</BOYAmt>
        <EOYAmt>8178675</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>200000</BOYAmt>
        <EOYAmt>50000</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>4758546</BOYAmt>
        <EOYAmt>2867706</EOYAmt>
      </AccountsReceivableGrp>
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      <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>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
    <ReasonableCauseExplanation documentId="R000008" softwareId="20012124" softwareVersionNum="v1.00">
      <ExplanationTxt>An Extension Form 8868 was filed and accepted by the IRS.</ExplanationTxt>
    </ReasonableCauseExplanation>
  </ReturnData>
</Return>