<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xsi:schemaLocation="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2021v4.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2022-11-10T06:10:26-06:00</ReturnTs>
    <TaxPeriodEndDt>2021-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmName>
        <BusinessNameLine1Txt>FORVIS LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>312 WALNUT STREET SUITE 3000</AddressLine1Txt>
        <CityNm>CINCINNATI</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>45202</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2021-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>341531817</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>ALLIANCE COMMUNITY HEALTH FOUNDATION</BusinessNameLine1Txt>
      </BusinessName>
      <InCareOfNm>% MICHAEL S HOOVER</InCareOfNm>
      <BusinessNameControlTxt>ALLI</BusinessNameControlTxt>
      <PhoneNum>3305966000</PhoneNum>
      <USAddress>
        <AddressLine1Txt>119 E STATE STREET</AddressLine1Txt>
        <CityNm>ALLIANCE</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44601</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MICHAEL HOOVER</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>3305966000</PhoneNum>
      <SignatureDt>2022-05-15</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>MICHAEL</PersonFirstNm>
        <PersonLastNm>HOOVER</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Aaron Hershberger</PreparerPersonNm>
      <PTIN>P00961884</PTIN>
      <PhoneNum>5136218300</PhoneNum>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2021</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="IRS990" referenceDocumentId="IRS990ScheduleO">
      <PrincipalOfficerNm>MICHAEL HOOVER</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>119 E STATE STREET</AddressLine1Txt>
        <CityNm>ALLIANCE</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44601</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>29399704</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>N/A</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1986</FormationYr>
      <LegalDomicileStateCd>OH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>THE ALLIANCE COMMUNITY HEALTH FOUNDATION'S MISSION IS TO SUPPORT THE HEALTH CARE NEEDS OF THE RESIDENTS OF ALLIANCE, OHIO.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>13</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>13</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>0</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>0</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>0</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>3546588</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>7648187</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>3546588</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>7648187</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>2138537</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>2904396</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>0</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>0</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>604195</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>735718</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>2742732</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>3640114</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>803856</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>4008073</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>74016465</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>79670480</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>0</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>0</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>74016465</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>79670480</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>THE ALLIANCE COMMUNITY HEALTH FOUNDATION'S MISSION IS TO SUPPORT THE HEALTH CARE NEEDS OF THE RESIDENTS OF ALLIANCE, OHIO.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>2904396</ExpenseAmt>
      <GrantAmt>2904396</GrantAmt>
      <Desc>ALLIANCE COMMUNITY HEALTH FOUNDATION PROVIDES GRANTS TO COMMUNITY ORGANIZATIONS TO ACHIEVE ITS MISSION OF SUPPORTING THE HEALTH CARE NEEDS OF THE RESIDENTS OF ALLIANCE, OHIO.</Desc>
      <TotalProgramServiceExpensesAmt>2904396</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="IRS990ScheduleD">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="IRS990ScheduleD">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="IRS990ScheduleD">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="IRS990ScheduleD">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="IRS990ScheduleD">true</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">false</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="IRS990ScheduleI">true</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="IRS990ScheduleI">false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>false</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="IRS990ScheduleR">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="IRS990ScheduleR">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="IRS990ScheduleR">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="IRS990ScheduleR">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>true</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <ExcsTaxSect4951Or4952Or4953Ind>false</ExcsTaxSect4951Or4952Or4953Ind>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>13</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>13</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>true</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>MICHAEL S HOOVER</PersonNm>
        <PhoneNum>3305967528</PhoneNum>
        <USAddress>
          <AddressLine1Txt>400 E STATE ST</AddressLine1Txt>
          <CityNm>ALLIANCE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44601</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>DARRYL DILLENBACK</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERESA GOLDEN-MCCLELLAND</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN GROSS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAT HEDDLESTON</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL HOOVER</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT INGLEDUE</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DUANE KUENTZ MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEBRA LEHRER MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID LUNDGREN</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RON LYONS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID MCALISTER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WOODY MCCALLUM</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DENNIS POSTIY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>false</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <TotalContributionsAmt>0</TotalContributionsAmt>
      <TotalProgramServiceRevenueAmt>0</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>4012363</TotalRevenueColumnAmt>
        <ExclusionAmt>4012363</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>25387341</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>21751517</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>3635824</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>3635824</TotalRevenueColumnAmt>
        <ExclusionAmt>3635824</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>7648187</TotalRevenueColumnAmt>
        <ExclusionAmt>7648187</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>2904396</TotalAmt>
        <ProgramServicesAmt>2904396</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>0</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>0</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>0</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>0</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>0</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>704918</TotalAmt>
        <ManagementAndGeneralAmt>704918</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>0</TotalAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>0</TotalAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>0</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>0</TotalAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>0</TotalAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>0</TotalAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>0</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS EXPENSE</Desc>
        <TotalAmt>30800</TotalAmt>
        <ManagementAndGeneralAmt>30800</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>3640114</TotalAmt>
        <ProgramServicesAmt>2904396</ProgramServicesAmt>
        <ManagementAndGeneralAmt>735718</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>25720</BOYAmt>
        <EOYAmt>38547</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>73990745</BOYAmt>
        <EOYAmt>79631933</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>74016465</BOYAmt>
        <EOYAmt>79670480</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>73130430</BOYAmt>
        <EOYAmt>78753168</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>886035</BOYAmt>
        <EOYAmt>917312</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>74016465</BOYAmt>
        <EOYAmt>79670480</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>74016465</BOYAmt>
        <EOYAmt>79670480</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>4008073</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>1645942</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <SupportingOrganization509a3Ind>X</SupportingOrganization509a3Ind>
      <SupportingOrgType3NonFuncInd>X</SupportingOrgType3NonFuncInd>
      <SupportedOrganizationsCnt>4</SupportedOrganizationsCnt>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>ALLIANCE COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>340714581</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>2720000</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>ALLIANCE FOR CHILDREN AND FAMILIES INC</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>341590276</EIN>
        <OrganizationTypeCd>7</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>0</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>GREATER ALLIANCE FOUNDATION INC</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>341873212</EIN>
        <OrganizationTypeCd>7</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>106396</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>ALLIANCE FAMILY HEALTH CENTER INC</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>810789614</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>78000</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrganizationsTotalCnt>4</SupportedOrganizationsTotalCnt>
      <SupportSumAmt>2904396</SupportSumAmt>
      <Form990SchASupportingOrgGrp>
        <ListedByNameGoverningDocInd>true</ListedByNameGoverningDocInd>
        <SuprtOrgNoIRSDeterminationInd>false</SuprtOrgNoIRSDeterminationInd>
        <SupportedOrgSectionC456Ind>false</SupportedOrgSectionC456Ind>
        <SupportedOrgNotOrganizedUSInd>false</SupportedOrgNotOrganizedUSInd>
        <OrganizationChangeSuprtOrgInd>false</OrganizationChangeSuprtOrgInd>
        <SupportNonSupportedOrgInd>false</SupportNonSupportedOrgInd>
        <PaymentSubstantialContribtrInd>false</PaymentSubstantialContribtrInd>
        <LoanDisqualifiedPersonInd>false</LoanDisqualifiedPersonInd>
        <ControlledDisqualifiedPrsnInd>false</ControlledDisqualifiedPrsnInd>
        <DisqualifiedPrsnControllIntInd>false</DisqualifiedPrsnControllIntInd>
        <DisqualifiedPrsnOwnrIntInd>false</DisqualifiedPrsnOwnrIntInd>
        <ExcessBusinessHoldingsRulesInd>false</ExcessBusinessHoldingsRulesInd>
        <ContributionControllerInd>false</ContributionControllerInd>
        <ContributionFamilyInd>false</ContributionFamilyInd>
        <Contribution35ControlledInd>false</Contribution35ControlledInd>
      </Form990SchASupportingOrgGrp>
      <Form990SchAType3SprtOrgAllGrp>
        <TimelyProvidedDocumentsInd>true</TimelyProvidedDocumentsInd>
        <OfficersCloseRelationshipInd>true</OfficersCloseRelationshipInd>
        <SupportedOrgVoiceInvestmentInd>false</SupportedOrgVoiceInvestmentInd>
      </Form990SchAType3SprtOrgAllGrp>
      <AdjustedNetIncomeGrp>
        <NetSTCapitalGainAdjNetIncmGrp>
          <PriorYearAmt>0</PriorYearAmt>
        </NetSTCapitalGainAdjNetIncmGrp>
        <RecoveriesPYDistributionsGrp>
          <PriorYearAmt>0</PriorYearAmt>
        </RecoveriesPYDistributionsGrp>
        <OtherGrossIncomeGrp>
          <PriorYearAmt>3546588</PriorYearAmt>
          <CurrentYearAmt>7648187</CurrentYearAmt>
        </OtherGrossIncomeGrp>
        <AdjustedGrossIncomeGrp>
          <PriorYearAmt>3546588</PriorYearAmt>
          <CurrentYearAmt>7648187</CurrentYearAmt>
        </AdjustedGrossIncomeGrp>
        <DepreciationDepletionGrp>
          <PriorYearAmt>0</PriorYearAmt>
        </DepreciationDepletionGrp>
        <ProductionIncomeGrp>
          <PriorYearAmt>0</PriorYearAmt>
        </ProductionIncomeGrp>
        <OtherExpensesGrp>
          <PriorYearAmt>604195</PriorYearAmt>
          <CurrentYearAmt>735718</CurrentYearAmt>
        </OtherExpensesGrp>
        <TotalAdjustedNetIncomeGrp>
          <PriorYearAmt>2942393</PriorYearAmt>
          <CurrentYearAmt>6912469</CurrentYearAmt>
        </TotalAdjustedNetIncomeGrp>
      </AdjustedNetIncomeGrp>
      <MinimumAssetAmountGrp>
        <AverageMonthlyFMVOfSecGrp>
          <PriorYearAmt>64441561</PriorYearAmt>
          <CurrentYearAmt>77286289</CurrentYearAmt>
        </AverageMonthlyFMVOfSecGrp>
        <AverageMonthlyCashBalancesGrp>
          <PriorYearAmt>65607</PriorYearAmt>
          <CurrentYearAmt>28013</CurrentYearAmt>
        </AverageMonthlyCashBalancesGrp>
        <FMVOtherNonExemptUseAssetGrp>
          <PriorYearAmt>0</PriorYearAmt>
        </FMVOtherNonExemptUseAssetGrp>
        <TotalFMVOfNonExemptUseAssetGrp>
          <PriorYearAmt>64507168</PriorYearAmt>
          <CurrentYearAmt>77314302</CurrentYearAmt>
        </TotalFMVOfNonExemptUseAssetGrp>
        <DiscountClaimedAmt>0</DiscountClaimedAmt>
        <AcquisitionIndebtednessGrp>
          <PriorYearAmt>0</PriorYearAmt>
        </AcquisitionIndebtednessGrp>
        <AdjustedFMVLessIndebtednessGrp>
          <PriorYearAmt>64507168</PriorYearAmt>
          <CurrentYearAmt>77314302</CurrentYearAmt>
        </AdjustedFMVLessIndebtednessGrp>
        <CashDeemedCharitableGrp>
          <PriorYearAmt>967608</PriorYearAmt>
          <CurrentYearAmt>1159715</CurrentYearAmt>
        </CashDeemedCharitableGrp>
        <NetVlNonExemptUseAssetsGrp>
          <PriorYearAmt>63539560</PriorYearAmt>
          <CurrentYearAmt>76154587</CurrentYearAmt>
        </NetVlNonExemptUseAssetsGrp>
        <PctOfNetVlNonExemptUseAstGrp>
          <PriorYearAmt>2223885</PriorYearAmt>
          <CurrentYearAmt>2665411</CurrentYearAmt>
        </PctOfNetVlNonExemptUseAstGrp>
        <RecoveriesPYDistriMinAssetGrp>
          <PriorYearAmt>0</PriorYearAmt>
        </RecoveriesPYDistriMinAssetGrp>
        <TotalMinimumAssetGrp>
          <PriorYearAmt>2223885</PriorYearAmt>
          <CurrentYearAmt>2665411</CurrentYearAmt>
        </TotalMinimumAssetGrp>
      </MinimumAssetAmountGrp>
      <DistributableAmountGrp>
        <CYAdjNetIncomeDistributableAmt>2942393</CYAdjNetIncomeDistributableAmt>
        <CYPct85AdjustedNetIncomeAmt>2501034</CYPct85AdjustedNetIncomeAmt>
        <CYTotalMinAstDistributableAmt>2223885</CYTotalMinAstDistributableAmt>
        <CYGreaterAdjustedMinimumAmt>2501034</CYGreaterAdjustedMinimumAmt>
        <CYIncomeTaxImposedPYAmt>0</CYIncomeTaxImposedPYAmt>
        <CYDistributableAsAdjustedAmt>2501034</CYDistributableAsAdjustedAmt>
      </DistributableAmountGrp>
      <DistributionsGrp>
        <CYPaidAccomplishExemptPrpsAmt>2904396</CYPaidAccomplishExemptPrpsAmt>
        <CYPdInExcessIncomeActivityAmt>0</CYPdInExcessIncomeActivityAmt>
        <CYAdministrativeExpensePaidAmt>0</CYAdministrativeExpensePaidAmt>
        <ExemptUseAssetsAcquisPaidAmt>0</ExemptUseAssetsAcquisPaidAmt>
        <QualifiedSetAsideAmt>0</QualifiedSetAsideAmt>
        <CYOtherDistributionsAmt>0</CYOtherDistributionsAmt>
        <CYTotalAnnualDistributionsAmt>2904396</CYTotalAnnualDistributionsAmt>
        <CYDistriAttentiveSuprtOrgAmt>2904396</CYDistriAttentiveSuprtOrgAmt>
        <CYDistributableAsAdjustedAmt>2501034</CYDistributableAsAdjustedAmt>
        <CYDistributionYrRt>116.1278</CYDistributionYrRt>
      </DistributionsGrp>
      <DistributionAllocationsGrp>
        <CYDistributableAsAdjustedAmt>2501034</CYDistributableAsAdjustedAmt>
        <UnderdistributionsAmt>0</UnderdistributionsAmt>
        <ExcessDistributionCyovYr5Amt>0</ExcessDistributionCyovYr5Amt>
        <ExcessDistributionCyovYr4Amt>0</ExcessDistributionCyovYr4Amt>
        <ExcessDistributionCyovYr3Amt>22818</ExcessDistributionCyovYr3Amt>
        <ExcessDistributionCyovYr2Amt>0</ExcessDistributionCyovYr2Amt>
        <ExcessDistributionCyovYr1Amt>315</ExcessDistributionCyovYr1Amt>
        <TotalExcessDistributionCyovAmt>23133</TotalExcessDistributionCyovAmt>
        <CyovAppliedUnderdistriPYAmt>0</CyovAppliedUnderdistriPYAmt>
        <CyovAppliedUnderdistrCPYAmt>0</CyovAppliedUnderdistrCPYAmt>
        <CarryoverPYNotAppliedAmt>0</CarryoverPYNotAppliedAmt>
        <ExcessDistributionCyovAmt>23133</ExcessDistributionCyovAmt>
        <CYTotalAnnualDistributionsAmt>2904396</CYTotalAnnualDistributionsAmt>
        <CYDistribAppUnderdistriPYAmt>0</CYDistribAppUnderdistriPYAmt>
        <CYDistriAppDistributableAmt>2501034</CYDistriAppDistributableAmt>
        <ExcessDistributionAmt>403362</ExcessDistributionAmt>
        <RemainingUnderdistriPYAmt>0</RemainingUnderdistriPYAmt>
        <RemainingUnderdistriCYAmt>0</RemainingUnderdistriCYAmt>
        <ExcessDistriCyovToNextYrAmt>426495</ExcessDistriCyovToNextYrAmt>
        <ExcessFromYear5Amt>0</ExcessFromYear5Amt>
        <ExcessFromYear4Amt>22818</ExcessFromYear4Amt>
        <ExcessFromYear3Amt>0</ExcessFromYear3Amt>
        <ExcessFromYear2Amt>315</ExcessFromYear2Amt>
        <ExcessFromYear1Amt>403362</ExcessFromYear1Amt>
      </DistributionAllocationsGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>886035</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>31277</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>917312</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>873213</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>12822</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>886035</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>860521</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>12692</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>873213</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>860521</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>860521</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>860521</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>860521</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <PrmnntEndowmentBalanceEOYPct>1.00000</PrmnntEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <LandGrp />
      <BuildingsGrp />
      <LeaseholdImprovementsGrp />
      <EquipmentGrp />
      <OtherLandBuildingsGrp />
      <TotalRevEtcAuditedFinclStmtAmt>8589211</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>1645942</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>1645942</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>6943269</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>704918</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>704918</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>7648187</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>2935196</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>2935196</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>704918</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>704918</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>3640114</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO HOLD THE PRINCIPAL IN PERPETUITY AND USE THE INTEREST FOR THE GENERAL OPERATIONS OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XI, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INVESTMENT EXPENSES: $704,918</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XII, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INVESTMENT EXPENSES: $704,918</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="IRS990ScheduleI">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ALLIANCE COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>200 E STATE STREET</AddressLine1Txt>
          <CityNm>ALLIANCE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44601</ZIPCd>
        </USAddress>
        <RecipientEIN>340714581</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>2720000</CashGrantAmt>
        <PurposeOfGrantTxt>HEALTH CARE SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ALLIANCE FAMILY HEALTH CENTER INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1401 S ARCH AVENUE</AddressLine1Txt>
          <CityNm>ALLIANCE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44601</ZIPCd>
        </USAddress>
        <RecipientEIN>810789614</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>78000</CashGrantAmt>
        <PurposeOfGrantTxt>HEALTH CARE SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>GREATER ALLIANCE FOUNDATION INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>960 W STATE STREET 130</AddressLine1Txt>
          <CityNm>ALLIANCE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44601</ZIPCd>
        </USAddress>
        <RecipientEIN>341873212</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>106396</CashGrantAmt>
        <PurposeOfGrantTxt>HEALTH CARE</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>3</Total501c3OrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PART I, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>ALLIANCE COMMUNITY HEALTH FOUNDATION GRANTS FUNDS TO ITS SUPPORTED ORGANIZATIONS FOR PURPOSES ALIGNED WITH ITS MISSION. ACHF RELIES ON ITS GRANT FUNDING PROCESS TO ENSURE THE USE OF THE GRANTED FUNDS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>VOTING MEMBERS THE GOVERNING BODY OF ALLIANCE COMMUNITY HEALTH FOUNDATION (PER ITS CODE OF REGULATIONS) HAS DELEGATED AUTHORITY TO THE BOARD OF ALLIANCE CITIZENS' HEALTH ASSOCIATION (THE MEMBER), A RELATED ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OR STOCKHOLDERS ALLIANCE CITIZENS' HEALTH ASSOCIATION IS THE SOLE MEMBER OF ALLIANCE COMMUNITY HEALTH FOUNDATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE POWER TO ELECT GOVERNING BODY THE GOVERNING BODY OF ALLIANCE COMMUNITY HEALTH FOUNDATION (PER ITS CODE OF REGULATIONS) HAS DELEGATED AUTHORITY TO THE BOARD OF ALLIANCE CITIZENS' HEALTH ASSOCIATION (THE MEMBER) THE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES AND/OR OFFICERS OF THE CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNANCE DECISIONS THE GOVERNING BODY OF ALLIANCE COMMUNITY HEALTH FOUNDATION (PER ITS CODE OF REGULATIONS) HAS DELEGATED AUTHORITY TO THE BOARD OF ALLIANCE CITIZENS' HEALTH ASSOCIATION (THE MEMBER), A RELATED ORGANIZATION, AS FOLLOWS: 1.) APPROVE THE ANNUAL OPERATING BUDGETS; CAPITAL EXPENDITURES BUDGETS, CAPITAL EXPENDITURES OR DISPOSITIONS OF CAPITAL ASSETS WITH A VALUE IN EXCESS OF SUCH LIMITS AS SHALL BE SET FROM TIME TO TIME BY THE MEMBER; ANY ACTION WHICH REQUIRES CERTIFICATE OF NEED APPROVAL FROM THE STATE HEALTH PLANNING DEVELOPMENT AGENCY; AND ANY PURCHASE, SALE, LEASE, DISPOSITION, OR HYPOTHECATION OF REAL PROPERTY; 2.) THE INCURRENCE OF ANY OBLIGATION(S), LIABILITY(IES), AND/OR DEBT(S) REQUIRING A MORTGAGE ON OR SECURITY INTEREST IN ANY PART OF THE ASSETS OF THE CORPORATION; 3.) POWER TO DETERMINE, UPON DISSOLUTION OF THE CORPORATION, THE ORGANIZATION OR ORGANIZATIONS TO WHICH ITS REMAINING ASSETS WILL BE DISTRIBUTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS OF THE REVIEW OF FORM 990 THE FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT CPA FIRM. PRIOR TO FILING, THE 990 IS ALSO DISTRIBUTED TO THE BOARD OF TRUSTEES FOR THEIR REVIEW AND COMMENTS. IT IS THEN DISCUSSED AS PART OF THE FINANCIAL REPORT AT THE NEXT BOARD MEETING WHERE ANY QUESTIONS/CONCERNS CAN BE ADDRESSED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION'S PRACTICE FOR MONITORING COMPLIANCE MEMBERS OF THE BOARD OF TRUSTEES ARE REQUIRED TO ANNUALLY REVIEW AND SIGN A CONFLICT OF INTEREST POLICY. UNDER THAT POLICY, THE BOARD MEMBER (i) HAS A DUTY TO DISCLOSE ANY CONFLICT, AND (ii) MUST RECUSE THEMSELVES FROM A VOTE AND/OR DECISION WHEN SUCH A CONFLICT ARISES. IF THIS POLICY IS VIOLATED, THEN THE BOARD SHALL TAKE APPROPRIATE ACTION WHICH MAY INCLUDE AN INVESTIGATION AND DISCIPLINARY ACTION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION REVIEW PROCESS NO COMPENSATION IS PAID BY ALLIANCE COMMUNITY HEALTH FOUNDATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENTS THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC VIA THE OHIO SECRETARY OF STATE'S WEBSITE. THE FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE CITIZENS' HEALTH ASSOCIATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>200 E STATE ST</AddressLine1Txt>
          <CityNm>ALLIANCE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44601</ZIPCd>
        </USAddress>
        <EIN>341531815</EIN>
        <PrimaryActivitiesTxt>FACILITY MGMT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12B</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
