<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2020v4.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2021-10-18T13:22:18-05:00</ReturnTs>
    <TaxPeriodEndDt>2020-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>200503877</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>SEBER TANS PLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>555 W CROSSTOWN PARKWAY STE 304</AddressLine1Txt>
        <CityNm>KALAMAZOO</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49008</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2020-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>382293985</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>HOSPICE CARE OF SOUTHWEST MICHIGAN</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>HOSP</BusinessNameControlTxt>
      <PhoneNum>2693450273</PhoneNum>
      <USAddress>
        <AddressLine1Txt>7100 STADIUM DRIVE</AddressLine1Txt>
        <CityNm>KALAMAZOO</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49009</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>SUSAN SPRINGGATE</PersonNm>
      <PersonTitleTxt>TREASURER</PersonTitleTxt>
      <PhoneNum>2693450273</PhoneNum>
      <SignatureDt>2021-10-18</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>SUSAN</PersonFirstNm>
        <PersonLastNm>SPRINGGATE</PersonLastNm>
      </PersonFullName>
      <SSN>888008888</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>THOMAS J HORWATH</PreparerPersonNm>
      <PTIN>P00548822</PTIN>
      <PhoneNum>2693438180</PhoneNum>
      <PreparationDt>2021-10-18</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2020</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc8">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>HOSPICE OF GREATER KALAMAZOO</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>KELLY MCCORMICK</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>7100 STADIUM DRIVE</AddressLine1Txt>
        <CityNm>KALAMAZOO</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49009</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>41110231</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.HOSPICESWMI.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1981</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>CARE FOR PEOPLE COPING WITH ILLNESS, AGING, DYING AND LOSS.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>15</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>15</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>357</TotalEmployeeCnt>
      <TotalVolunteersCnt>217</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>824814</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>2273427</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>26549170</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>34088423</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1340025</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>1007696</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>61834</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>40507</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>28775843</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>37410053</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>18962178</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>23553411</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>214293</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>9180793</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>11295689</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>28142971</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>34849100</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>632872</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>2560953</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>54407731</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>68641942</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>3597358</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>11493805</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>50810373</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>57148137</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>CARE FOR PEOPLE COPING WITH ILLNESS, AGING, DYING AND LOSS.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>24344804</ExpenseAmt>
      <RevenueAmt>31829925</RevenueAmt>
      <Desc>MEDICAL SERVICES - THE FOLLOWING SERVICES ARE PROVIDED THROUGH HOSPICE: AS NEEDED AND AS APPROPRIATE-NURSING SERVICES, MEDICAL SOCIAL WORK, PHYSICIAN SERVICES, SPIRITUAL COUNSELING, TRAINED VOLUNTEERS, PHYSICAL THERAPY, NUTRITIONAL COUNSELING, OCCUPATIONAL THERAPY, SPEECH AND LANGUAGE THERAPY, HOME HEALTH AIDE SERVICES, HOMEMAKER SERVICES, SHORT-TERM INPATIENT CARE, SHORT-TERM CONTINUOUS CARE, SHORT-TERM RESPITE INPATIENT CARE, AND GRIEF SERVICES. ALSO PROVIDED ARE RELATED MEDICAL SUPPLIES, MEDICATION, AND DURABLE MEDICAL EQUIPMENT.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>1600217</ExpenseAmt>
        <RevenueAmt>420409</RevenueAmt>
        <Desc>SOCIAL WORK AND SPIRITUAL COUNSELING SERVICES - SOCIAL WORK AND SPIRITUAL COUNSELING SERVICES PROVIDED AS PART OF THE OVERALL HOSPICE PROGRAM TO HOSPICE CLIENTS AND THEIR FAMILIES.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>282174</ExpenseAmt>
        <RevenueAmt>140353</RevenueAmt>
        <Desc>ADULT DAY SERVICES - CARE FOR THOSE WHO ARE PHYSICALLY FRAIL, HAVE DEMENTIA, OR NEED EXTRA ASSISTANCE. ALSO CARE FOR OLDER ADULTS WHO ENJOY THE MEANINGFUL ACTIVITIES AND SOCIAL ENGAGEMENT OFFERED BY THE PROGRAM.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>663674</ExpenseAmt>
        <RevenueAmt>1500439</RevenueAmt>
        <Desc>VOLUNTEER SERVICES - COORDINATION OF TRAINING AND SERVICES PROVIDED BY HOSPICE VOLUNTEERS. BEREAVEMENT SERVICES - GRIEF COUNSELING SERVICES PROVIDED TO BEREAVED FOR THIRTEEN MONTHS AFTER A LOVED ONE'S DEATH AND GRIEF SUPPORT SERVICES PROVIDED TO COMMUNITY MEMBERS WHO HAVE EXPERIENCED GRIEF OR LOSS. MANAGE THE ADVANCED ILLNESS MANAGEMENT (AIM) PROGRAM FOR BRONSON HOSPITAL.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>663674</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcRevenueAmt>1500439</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>26890869</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc9">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc3">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc3">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc3">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc3">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc3">true</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc3">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc3">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc3">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc3">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc3">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc3">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc3">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc3">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentId="RetDoc4">false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="RetDoc4">true</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentId="RetDoc4">false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc5">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="RetDoc6">true</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>false</InvestTaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="RetDoc7">true</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="RetDoc7">false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>68</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>357</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>true</QuidProQuoContributionsInd>
      <QuidProQuoContriDisclInd>true</QuidProQuoContriDisclInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>15</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>15</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</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>
      <StatesWhereCopyOfReturnIsFldCd>MI</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>JAMIE COCKEREL</PersonNm>
        <PhoneNum>2693450273</PhoneNum>
        <USAddress>
          <AddressLine1Txt>7100 STADIUM DRIVE</AddressLine1Txt>
          <CityNm>KALAMAZOO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49009</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR MICHAEL RAPHELSON</PersonNm>
        <TitleTxt>MEDICAL DIRE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>328052</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25681</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR RONALD SEAGLE</PersonNm>
        <TitleTxt>HOSPICE PHYS</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>270207</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28377</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLY MCCORMICK</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>225043</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8018</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAUL GRAY</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>152819</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21053</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMIE COCKEREL</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>148069</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13059</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSHUA FITZGIBBON</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TOM JAGER</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN SPRINGGATE</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHARLIE OFSTEIN</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIN GALLAGHER</PersonNm>
        <TitleTxt>PAST TREASUR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PHILIP A LONG</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRENDA MURPHY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CELIA BANUELOS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WENDY Y FIELDS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID WARREN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KENNETH WARREN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.75</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL LIEHR</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JERRY POTRATZ</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.75</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR CHERYL DICKSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FR JOHN FLECKENSTEIN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL LIEHR</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1124190</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>96188</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>5</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <FederatedCampaignsAmt>23130</FederatedCampaignsAmt>
      <FundraisingAmt>186394</FundraisingAmt>
      <AllOtherContributionsAmt>2063903</AllOtherContributionsAmt>
      <NoncashContributionsAmt>289958</NoncashContributionsAmt>
      <TotalContributionsAmt>2273427</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAL SERVICES</Desc>
        <BusinessCd>623110</BusinessCd>
        <TotalRevenueColumnAmt>31632628</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>31632628</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER PROGRAM SERVICES</Desc>
        <BusinessCd>624190</BusinessCd>
        <TotalRevenueColumnAmt>1697736</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1697736</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SOCIAL WORK AND COUNSELING</Desc>
        <BusinessCd>624120</BusinessCd>
        <TotalRevenueColumnAmt>420409</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>420409</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ADVANCED ILLNESS MANAGEMENT</Desc>
        <BusinessCd>624190</BusinessCd>
        <TotalRevenueColumnAmt>197297</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>197297</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ADULT DAYCARE</Desc>
        <BusinessCd>624190</BusinessCd>
        <TotalRevenueColumnAmt>140353</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>140353</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>34088423</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>721849</TotalRevenueColumnAmt>
        <ExclusionAmt>721849</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>3906625</SecuritiesAmt>
        <OtherAmt>71183</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>3691961</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>214664</SecuritiesAmt>
        <OtherAmt>71183</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>285847</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>285847</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>41369</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>186394</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>8217</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>33152</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>7355</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7355</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>7355</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>37410053</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>34381625</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>721849</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>394189</TotalAmt>
        <ManagementAndGeneralAmt>394189</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>18593639</TotalAmt>
        <ProgramServicesAmt>14373914</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4054180</ManagementAndGeneralAmt>
        <FundraisingAmt>165545</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>279723</TotalAmt>
        <ProgramServicesAmt>208152</ProgramServicesAmt>
        <ManagementAndGeneralAmt>69140</ManagementAndGeneralAmt>
        <FundraisingAmt>2431</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2314309</TotalAmt>
        <ProgramServicesAmt>1673058</ProgramServicesAmt>
        <ManagementAndGeneralAmt>621708</ManagementAndGeneralAmt>
        <FundraisingAmt>19543</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1971551</TotalAmt>
        <ProgramServicesAmt>1418259</ProgramServicesAmt>
        <ManagementAndGeneralAmt>536725</ManagementAndGeneralAmt>
        <FundraisingAmt>16567</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>34069</TotalAmt>
        <ManagementAndGeneralAmt>34069</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>31935</TotalAmt>
        <ManagementAndGeneralAmt>31935</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>157296</TotalAmt>
        <ManagementAndGeneralAmt>157296</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>567013</TotalAmt>
        <ProgramServicesAmt>325882</ProgramServicesAmt>
        <ManagementAndGeneralAmt>241131</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>33847</TotalAmt>
        <ProgramServicesAmt>33847</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>334044</TotalAmt>
        <ProgramServicesAmt>85440</ProgramServicesAmt>
        <ManagementAndGeneralAmt>239759</ManagementAndGeneralAmt>
        <FundraisingAmt>8845</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>751117</TotalAmt>
        <ProgramServicesAmt>129781</ProgramServicesAmt>
        <ManagementAndGeneralAmt>621336</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>412467</TotalAmt>
        <ProgramServicesAmt>241342</ProgramServicesAmt>
        <ManagementAndGeneralAmt>171125</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>5390</TotalAmt>
        <ProgramServicesAmt>5197</ProgramServicesAmt>
        <ManagementAndGeneralAmt>193</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>588156</TotalAmt>
        <ProgramServicesAmt>390243</ProgramServicesAmt>
        <ManagementAndGeneralAmt>197913</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>138916</TotalAmt>
        <ManagementAndGeneralAmt>138916</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>ROOM AND BOARD</Desc>
        <TotalAmt>3493747</TotalAmt>
        <ProgramServicesAmt>3493747</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PRESCRIPTION DRUGS</Desc>
        <TotalAmt>1871435</TotalAmt>
        <ProgramServicesAmt>1871435</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PATIENT SERVICE EXPENSE</Desc>
        <TotalAmt>1282117</TotalAmt>
        <ProgramServicesAmt>1282117</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>770966</TotalAmt>
        <ProgramServicesAmt>770966</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>823174</TotalAmt>
        <ProgramServicesAmt>587489</ProgramServicesAmt>
        <ManagementAndGeneralAmt>234323</ManagementAndGeneralAmt>
        <FundraisingAmt>1362</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>34849100</TotalAmt>
        <ProgramServicesAmt>26890869</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7743938</ManagementAndGeneralAmt>
        <FundraisingAmt>214293</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>230994</BOYAmt>
        <EOYAmt>264901</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>2299187</BOYAmt>
        <EOYAmt>7142343</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>3577435</BOYAmt>
        <EOYAmt>5029789</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>365560</BOYAmt>
        <EOYAmt>231441</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>19198337</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>9297848</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>9926212</BOYAmt>
        <EOYAmt>9900489</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>36306939</BOYAmt>
        <EOYAmt>40941032</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1701404</BOYAmt>
        <EOYAmt>5131947</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>54407731</BOYAmt>
        <EOYAmt>68641942</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2749561</BOYAmt>
        <EOYAmt>4997791</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>594322</BOYAmt>
        <EOYAmt>482885</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <EOYAmt>2222805</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>253475</BOYAmt>
        <EOYAmt>3790324</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3597358</BOYAmt>
        <EOYAmt>11493805</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>46527031</BOYAmt>
        <EOYAmt>52389311</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>4283342</BOYAmt>
        <EOYAmt>4758826</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>50810373</BOYAmt>
        <EOYAmt>57148137</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>54407731</BOYAmt>
        <EOYAmt>68641942</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>2560953</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>3776811</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc9">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>919914</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>641675</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>697379</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>824814</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2273427</CurrentTaxYearAmt>
        <TotalAmt>5357209</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>919914</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>641675</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>697379</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>824814</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2273427</CurrentTaxYearAmt>
        <TotalAmt>5357209</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>107582</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>5249627</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>603584</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>711920</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>795600</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>801041</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>721849</CurrentTaxYearAmt>
        <TotalAmt>3633994</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <CurrentTaxYearMinus4YearsAmt>67037</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>66049</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>65853</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>45168</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>33153</CurrentTaxYearAmt>
        <TotalAmt>277260</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>7524</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8216</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9932</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16666</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7354</CurrentTaxYearAmt>
        <TotalAmt>49692</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>9318155</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>121112529</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.56340</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.48400</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART II, LINE 10</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME 49,692</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <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="RetDoc3">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>3658126</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>537924</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>11889</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>4184161</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>3036227</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>632963</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>11064</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3658126</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>3163061</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>-116196</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>10638</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3036227</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>3542301</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>431430</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>800000</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>10670</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3163061</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>3326141</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>227548</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>11388</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3542301</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <TermEndowmentBalanceEOYPct>1.00000</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>true</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>1150633</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1150633</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>13134621</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4925825</DepreciationAmt>
        <BookValueAmt>8208796</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>326182</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>128365</DepreciationAmt>
        <BookValueAmt>197817</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>4586901</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4243658</DepreciationAmt>
        <BookValueAmt>343243</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>9900489</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>CONSTRUCTION IN PROCESS</Desc>
        <BookValueAmt>4920494</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT OF USE ASSET - OPERATIN</Desc>
        <BookValueAmt>135619</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT OF USE ASSET - FINANCING</Desc>
        <BookValueAmt>75834</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>5131947</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>PPP LOAN</Desc>
        <Amt>3576400</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITY - OPERATING</Desc>
        <Amt>135851</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITY - FINANCING</Desc>
        <Amt>78073</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>3790324</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>41037784</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>3776811</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>8216</OtherRevenueAmt>
      <RevenueNotReportedAmt>3785027</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>37252757</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>157296</InvestmentExpensesNotIncldAmt>
      <RevenueNotReportedFinclStmtAmt>157296</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>37410053</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>34700020</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>8216</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>8216</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>34691804</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>157296</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>157296</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>34849100</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 2, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ENDOWMENT ACCOUNT WAS ESTABLISHED WITH FUNDS DONATED FOR THE PRIMARY PURPOSE OF PROVIDING AN ENDOWMENT FOR FUNDING THE OPERATIONS OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM TAX UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3) (THE "CODE"). THE ORGANIZATION IS REQUIRED TO OPERATE IN CONFORMITY WITH THE CODE AND RELATED REGULATIONS TO MAINTAIN ITS EXEMPTION. THE ORGANIZATION HAS NO UNRELATED BUSINESS INCOME, AS DEFINED BY SECTION 512 (A)(I) OF THE CODE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>FUNDRAISING EXPENSES 8,216</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XII, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>DIRECT FUNDRAISING EXPENSES 8,216</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc4">
      <FundraisingEventInformationGrp>
        <Event1Nm>GOLF FORE HOSPI</Event1Nm>
        <GrossReceiptsEvent1Amt>14575</GrossReceiptsEvent1Amt>
        <GrossRevenueEvent1Amt>14575</GrossRevenueEvent1Amt>
        <RentFacilityCostsEvent1Amt>3612</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>903</FoodAndBeverageEvent1Amt>
        <OtherDirectExpensesEvent1Amt>872</OtherDirectExpensesEvent1Amt>
        <Event2Nm>.1K RACE</Event2Nm>
        <GrossReceiptsEvent2Amt>11565</GrossReceiptsEvent2Amt>
        <GrossRevenueEvent2Amt>11565</GrossRevenueEvent2Amt>
        <OtherDirectExpensesEvent2Amt>970</OtherDirectExpensesEvent2Amt>
        <OtherEventsTotalCnt>1</OtherEventsTotalCnt>
        <GrossReceiptsOtherEventsAmt>201623</GrossReceiptsOtherEventsAmt>
        <CharitableContriOtherEventsAmt>186394</CharitableContriOtherEventsAmt>
        <GrossRevenueOtherEventsAmt>15229</GrossRevenueOtherEventsAmt>
        <OthDirectExpnssOtherEventsAmt>1860</OthDirectExpnssOtherEventsAmt>
        <GrossReceiptsTotalAmt>227763</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>186394</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>41369</GrossRevenueTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>3612</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>903</FoodAndBeverageTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>3702</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>8217</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>33152</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
      <StatesWhereGamingConductedCd>MI</StatesWhereGamingConductedCd>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="RetDoc5">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR MICHAEL RAPHELSON</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>324202</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>3850</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>3939</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>21742</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>353733</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR RONALD SEAGLE</PersonNm>
        <TitleTxt>HOSPICE PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>266357</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>3850</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>6701</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>21676</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>298584</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KELLY MCCORMICK</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>197743</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>27300</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>5255</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>2763</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>233061</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL GRAY</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>151769</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1050</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>4358</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16695</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>173872</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMIE COCKEREL</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>147019</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1050</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>4378</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8681</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>161128</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc6">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>MICHIGAN STATE HOSPITAL FINANCE</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>AUTHORITY</BusinessNameLine2Txt>
        </IssuerName>
        <BondIssuedDt>2005-03-17</BondIssuedDt>
        <IssuePriceAmt>2227000</IssuePriceAmt>
        <PurposeDesc>HEALTH CARE BUILDING AND EQUIPMENT</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>1744115</RetiredAmt>
        <TotalProceedsAmt>2227000</TotalProceedsAmt>
        <CapitalExpendituresAmt>2227000</CapitalExpendituresAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>false</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>false</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PURPOSE OF ISSUE DESCRIPTION</FormAndLineReferenceDesc>
        <ExplanationTxt>MICHIGAN STATE HOSPITAL FINANCE HEALTH CARE BUILDING AND EQUIPMENT</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="RetDoc7">
      <SecuritiesMiscellaneousGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>289958</NoncashContributionsRptF990Amt>
      </SecuritiesMiscellaneousGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc8">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS GUARANTEED THE DEBT UP TO 500,000 FOR THE PACE PROGRAM LOCATED IN KALAMAZOO, MI.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>VOLUNTEER SERVICES - COORDINATION OF TRAINING AND SERVICES PROVIDED BY HOSPICE VOLUNTEERS. BEREAVEMENT SERVICES - GRIEF COUNSELING SERVICES PROVIDED TO BEREAVED FOR THIRTEEN MONTHS AFTER A LOVED ONE'S DEATH AND GRIEF SUPPORT SERVICES PROVIDED TO COMMUNITY MEMBERS WHO HAVE EXPERIENCED GRIEF OR LOSS. MANAGE THE ADVANCED ILLNESS MANAGEMENT (AIM) PROGRAM FOR BRONSON HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCE COMMITTEE REVIEWS THE 990 PRIOR TO FILING. THE TREASURER SIGNS THE RETURN. ADDITIONALLY, ALL MEMBERS OF THE BOARD RECEIVE A COPY OF THE 990 PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>AT THE TIME OF JOINING THE BOARD, EACH MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT. EACH MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. ADDITIONALLY, BOARD MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST PROMPTLY. THE BOARD, EXCLUDING THE CONFLICTED MEMBER, WILL REVIEW AND ACT AS DICTATED BY THE CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHIEF HUMAN RESOURCES OFFICER USES ESTABLISHED OUTSIDE SURVEYS AS A MARKET ANALYSIS OF COMPENSATION FOR ALL POSITIONS, INCLUDING THE CEO AND OTHER TOP MANAGEMENT POSITIONS. THE CHIEF HUMAN RESOURCES OFFICER PROVIDES THE EXECUTIVE COMMITTEE WITH SALARY DATA FOR THE CEO ALONG WITH DATA OBTAINED FROM A COMPENSATION CONSULTANT. ON AN ANNUAL BASIS, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES THE CEO'S SALARY. THE INFORMATION IS MADE AVAILABLE TO THE BOARD IF REQUESTED. THE EXECUTIVE COMMITTEE ALSO COMPLETES A FORMAL EVALUATION OF THE CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHIEF HUMAN RESOURCES OFFICER USES ESTABLISHED OUTSIDE SURVEYS, ALONG WITH DATA OBTAINED FROM A COMPENSATION CONSULTANT, AS A MARKET ANALYSIS OF COMPENSATION. THE SALARY DATA IS REVIEWED BY THE CEO. THE INFORMATION IS MADE AVAILABLE TO THE BOARD IF REQUESTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENTS ARE AVAILABLE ON SITE FOR REVIEW UPON REQUEST. IF NECESSARY, COPIES CAN BE MADE FOR A SMALL FEE THAT WILL COVER THE ADMINISTRATIVE COST OF COPYING THE DOCUMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>FUNDRAISING EXPENSES 8,216 DIRECT FUNDRAISING EXPENSES -8,216</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
