﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2023v6.0" xsi:schemaLocation="http://www.irs.gov/efile">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-08-12T09:52:14-07:00</ReturnTs>
    <TaxPeriodEndDt>2024-09-30</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-10-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>831842463</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>BVM-PHS SENIOR HOUSING INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>BVM-</BusinessNameControlTxt>
      <PhoneNum>6516316162</PhoneNum>
      <USAddress>
        <AddressLine1Txt>2845 N HAMLINE AVE</AddressLine1Txt>
        <CityNm>ROSEVILLE</CityNm>
        <StateAbbreviationCd>MN</StateAbbreviationCd>
        <ZIPCd>55113</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MARK MEYER</PersonNm>
      <PersonTitleTxt>CFO/TREASURER</PersonTitleTxt>
      <SignatureDt>2025-08-12</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="IRS990" referenceDocumentId="IRS990ScheduleO" softwareId="23017517" softwareVersionNum="2023v6.0">
      <PrincipalOfficerNm>JONATHAN FLETCHER</PrincipalOfficerNm>
      <GrossReceiptsAmt>18289482</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.PRESHOMES.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2018</FormationYr>
      <LegalDomicileStateCd>IA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO HONOR GOD BY ENRICHING THE LIVES AND TOUCHING THE HEARTS OF OLDER ADULTS.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>4</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>4</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>71</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>1120409</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>644237</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>12723930</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>17250329</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>16415</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>23684</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>249296</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>370886</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>14110050</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>18289136</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>7283</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>11235</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>7293887</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>8511969</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>8348082</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>10626087</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>15649252</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>19149291</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-1539202</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-860155</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>91987522</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>91477588</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>84447029</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>81797250</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>7540493</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>9680338</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>TO HONOR GOD BY ENRICHING THE LIVES AND TOUCHING THE HEARTS OF OLDER ADULTS.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>16663836</ExpenseAmt>
      <GrantAmt>11235</GrantAmt>
      <RevenueAmt>17250329</RevenueAmt>
      <Desc>THE ORGANIZATION IS LOCATED IN DUBUQUE IOWA. PHASE I OF THE PROJECT CONSISTS OF 21 APARTMENTS THAT ARE MEMORY CARE ASSISTED LIVING AND 40 TRADITIONAL ASSISTED LIVING APARTMENTS. THE CAMPUS ALSO HAS 60 SKILLED NURING FACILITY BEDS. PHASE II OPENED IN FEBRUARY 2023 AND ADDED 116 INDEPENDENT LIVING APARTMENTS.</Desc>
      <TotalProgramServiceExpensesAmt>16663836</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</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">true</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="IRSScheduleD">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD">true</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">false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="IRS990ScheduleI">true</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="IRS990ScheduleK.1">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>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>
      <BackupWthldComplianceInd>false</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <Form8282FiledCnt>0</Form8282FiledCnt>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>4</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>4</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>true</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>false</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MN</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>HEIDI PETERSON</PersonNm>
        <PhoneNum>6516316162</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2845 N HAMLINE AVE</AddressLine1Txt>
          <CityNm>ROSEVILLE</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55113</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAN LINDH</PersonNm>
        <TitleTxt>CEO/BD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1063597</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26250</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK MEYER</PersonNm>
        <TitleTxt>CFO/TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>479100</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21646</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JON FLETCHER</PersonNm>
        <TitleTxt>VP-DEVELOPMENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>380084</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28580</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK PEDERSON</PersonNm>
        <TitleTxt>SVP, SITE OPERATIONS</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>273581</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21854</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SARAH RENTZ</PersonNm>
        <TitleTxt>CAMPUS ADMIN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>106748</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15753</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATIE HUNTINGTON</PersonNm>
        <TitleTxt>CLINICAL ADMIN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>106317</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11124</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LADONNA MANTERNACH</PersonNm>
        <TitleTxt>BOARD CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALAN STACHE</PersonNm>
        <TitleTxt>BOARD SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>213065</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>2196362</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>125207</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>2</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CONLON CONSTRUCTION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>501 BELL STREET SUITE 402</AddressLine1Txt>
            <CityNm>DUBUQUE</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>52001</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION SERVICES</ServicesDesc>
        <CompensationAmt>945933</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GOLF GREEN LAWNCARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>36131 W 76TH STREET SUITE 6</AddressLine1Txt>
            <CityNm>DAVENPORT</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>52806</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LAWNCARE SERVICES</ServicesDesc>
        <CompensationAmt>198058</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PHS MANAGEMENT LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2845 HAMLINE AVE N</AddressLine1Txt>
            <CityNm>ROSEVILLE</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>55113</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MANAGEMENT FEES</ServicesDesc>
        <CompensationAmt>746001</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TOTALITY STAFFING &amp; CONSULTING</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5900 SARAOTA ROAD SUITE 11</AddressLine1Txt>
            <CityNm>ASBURY</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>52002</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TEMP STAFFING</ServicesDesc>
        <CompensationAmt>157820</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>FUSION MEDICAL STAFFING LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>18881 W DODGE STREET STE 300W</AddressLine1Txt>
            <CityNm>ELKHORN</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68022</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TEMP STAFFING</ServicesDesc>
        <CompensationAmt>102420</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>573016</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>71221</GovernmentGrantsAmt>
      <TotalContributionsAmt>644237</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>SENIOR CARE SERVICES</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>17250329</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>17250329</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>17250329</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>23684</TotalRevenueColumnAmt>
        <ExclusionAmt>23684</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>472</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>472</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>472</TotalRevenueColumnAmt>
        <ExclusionAmt>472</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <CostOfGoodsSoldAmt>346</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-346</TotalRevenueColumnAmt>
        <ExclusionAmt>-346</ExclusionAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>BEAUTY SHOP REVENUE</Desc>
        <BusinessCd>446199</BusinessCd>
        <TotalRevenueColumnAmt>116280</TotalRevenueColumnAmt>
        <ExclusionAmt>116280</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CULINARY REVENUE</Desc>
        <BusinessCd>722210</BusinessCd>
        <TotalRevenueColumnAmt>113114</TotalRevenueColumnAmt>
        <ExclusionAmt>113114</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>81012</TotalRevenueColumnAmt>
        <ExclusionAmt>81012</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>60354</TotalRevenueColumnAmt>
        <ExclusionAmt>60354</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>370760</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>18289136</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>17250329</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>394570</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>11235</TotalAmt>
        <ProgramServicesAmt>11235</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>0</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6956499</TotalAmt>
        <ProgramServicesAmt>6389360</ProgramServicesAmt>
        <ManagementAndGeneralAmt>567139</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>125584</TotalAmt>
        <ProgramServicesAmt>115346</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10238</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>916407</TotalAmt>
        <ProgramServicesAmt>841696</ProgramServicesAmt>
        <ManagementAndGeneralAmt>74711</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>513479</TotalAmt>
        <ProgramServicesAmt>471617</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41862</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>746001</TotalAmt>
        <ManagementAndGeneralAmt>746001</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>5396</TotalAmt>
        <ManagementAndGeneralAmt>5396</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>16485</TotalAmt>
        <ManagementAndGeneralAmt>16485</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>542930</TotalAmt>
        <ProgramServicesAmt>542174</ProgramServicesAmt>
        <ManagementAndGeneralAmt>756</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>53676</TotalAmt>
        <ProgramServicesAmt>12645</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41031</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>211090</TotalAmt>
        <ProgramServicesAmt>124932</ProgramServicesAmt>
        <ManagementAndGeneralAmt>86158</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>173976</TotalAmt>
        <ManagementAndGeneralAmt>173976</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>936439</TotalAmt>
        <ProgramServicesAmt>720813</ProgramServicesAmt>
        <ManagementAndGeneralAmt>215626</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>41221</TotalAmt>
        <ProgramServicesAmt>41221</ProgramServicesAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>7077</TotalAmt>
        <ProgramServicesAmt>7077</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>2850299</TotalAmt>
        <ProgramServicesAmt>2850299</ProgramServicesAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>3156265</TotalAmt>
        <ProgramServicesAmt>3156265</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>243135</TotalAmt>
        <ManagementAndGeneralAmt>243135</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>BUILDING - CONTRACTS/MAINT</Desc>
        <TotalAmt>591995</TotalAmt>
        <ProgramServicesAmt>591995</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FOOD</Desc>
        <TotalAmt>551250</TotalAmt>
        <ProgramServicesAmt>551250</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>262988</TotalAmt>
        <ProgramServicesAmt>47</ProgramServicesAmt>
        <ManagementAndGeneralAmt>262941</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>235864</TotalAmt>
        <ProgramServicesAmt>235864</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>19149291</TotalAmt>
        <ProgramServicesAmt>16663836</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2485455</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <EOYAmt>0</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>3173723</BOYAmt>
        <EOYAmt>4277778</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1254634</BOYAmt>
        <EOYAmt>1081145</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>13874</BOYAmt>
        <EOYAmt>21233</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>92074112</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>7520563</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>86541818</BOYAmt>
        <EOYAmt>84553549</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>124801</BOYAmt>
        <EOYAmt>736393</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>878672</BOYAmt>
        <EOYAmt>802405</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <EOYAmt>5085</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>91987522</BOYAmt>
        <EOYAmt>91477588</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1253089</BOYAmt>
        <EOYAmt>1407954</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>58536184</BOYAmt>
        <EOYAmt>57355797</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>1043000</BOYAmt>
        <EOYAmt>1066300</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>23614756</BOYAmt>
        <EOYAmt>21967199</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>84447029</BOYAmt>
        <EOYAmt>81797250</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>7540493</BOYAmt>
        <EOYAmt>9680338</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>7540493</BOYAmt>
        <EOYAmt>9680338</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>91987522</BOYAmt>
        <EOYAmt>91477588</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-860155</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>3000000</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>false</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="23017517" softwareVersionNum="2023v6.0">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus3YearsAmt>160000</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>196536</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1120409</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>644237</CurrentTaxYearAmt>
        <TotalAmt>2121182</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus3YearsAmt>6180350</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9223457</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12723930</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>17250329</CurrentTaxYearAmt>
        <TotalAmt>45378066</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <CurrentTaxYearMinus1YearAmt>9353</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>289748</CurrentTaxYearAmt>
        <TotalAmt>299101</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <GovtFurnSrvcFcltsVl509Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus3YearsAmt>6340350</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9419993</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13853692</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>18184314</CurrentTaxYearAmt>
        <TotalAmt>47798349</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <CurrentTaxYearMinus2YearsAmt>940621</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>308761</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>1249382</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus2YearsAmt>940621</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>308761</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>1249382</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>46548967</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>105</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1009</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>931</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>6204</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24156</CurrentTaxYearAmt>
        <TotalAmt>32405</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <TotalAmt>0</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>105</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1009</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>931</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>6204</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24156</CurrentTaxYearAmt>
        <TotalAmt>32405</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <TotalAmt>0</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus3YearsAmt>79883</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>63642</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>135818</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>81012</CurrentTaxYearAmt>
        <TotalAmt>360355</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>105</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>6421242</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9484566</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13995714</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>18289482</CurrentTaxYearAmt>
        <TotalAmt>48191109</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.96590</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.94860</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00070</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00030</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="23017517" softwareVersionNum="2023v6.0">
      <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="IRS990ScheduleD" softwareId="23017517" softwareVersionNum="2023v6.0">
      <AgentTrusteeEtcInd>false</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>true</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>3171031</OtherCostOrOtherBasisAmt>
        <BookValueAmt>3171031</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>78555773</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>5283267</DepreciationAmt>
        <BookValueAmt>73272506</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>2044326</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>224855</DepreciationAmt>
        <BookValueAmt>1819471</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>8302982</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2012441</DepreciationAmt>
        <BookValueAmt>6290541</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>84553549</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>DEBT SERVICE RESERVE</Desc>
        <BookValueAmt>535406</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATES</Desc>
        <Amt>718314</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>SUBORDINATED NOTE PAYABLE</Desc>
        <Amt>21248885</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>21967199</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>18289136</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>18289136</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>18289136</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>19149291</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>19149291</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>19149291</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IV, Line 2b: Explanation of escrow account liability</FormAndLineReferenceDesc>
        <ExplanationTxt>RESIDENT NOTES ARE REPORTED AS LONG TERM LIABILITY ON THE STATEMENTS OF FINANCIAL POSITION. THE RESIDENT NOTE IS REPAYABLE 120 DAYS AFTER MOVE OUT OF THE RESIDENT. THE DEPOSITS THAT ARE REPAYABLE AS A RESULT OF THE RESIDENT MOVING OUT WILL BE REPAID FROM THE PROCEEDS OF THE NEXT RESIDENT MOVING IN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X : FIN48 Footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION AND ITS AFFILIATES ARE GENERALLY EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE SECTIONS OF THE STATE STATUTES; CONSEQUENTLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. HOWEVER, THERE ARE IMMATERIAL AMOUNTS OF UNRELATED BUSINESS INCOME IN CERTAIN AFFILIATES THAT ARE TAXABLE.THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE ORGANIZATION FILES INFORMATION RETURNS AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="IRS990ScheduleI" softwareId="23017517" softwareVersionNum="2023v6.0">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <Total501c3OrgCnt>0</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>SCHOLARSHIPS</GrantTypeTxt>
        <RecipientCnt>3</RecipientCnt>
        <CashGrantAmt>11235</CashGrantAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Additional Supplemental Information</FormAndLineReferenceDesc>
        <ExplanationTxt>INDIVIDUAL SCHOLARSHIP RECIPIENTS MUST BE EMPLOYED BY PHS FOR AT LEAST THREE MONTHS, WORK AN AVERAGE OF 10 HOURS A WEEK, MAINTAIN AN EXCELLENT WORK RECORD, PROVIDE PROOF OF ACCEPTANCE OR ENROLLMENT IN A DEGREED PROGRAM, RECEIVE THE ENDORSEMENT OF THEIR MANAGER, CAMPUS ADMINISTRATOR, AND BY THEIR HUMAN RESOURCES REPRESENTATIVE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="23017517" softwareVersionNum="2023v6.0">
      <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>DAN LINDH</PersonNm>
        <TitleTxt>CEO/BD MEMBER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>1034206</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>29391</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>15000</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>11250</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>1089847</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JON FLETCHER</PersonNm>
        <TitleTxt>VP-DEVELOPMENT</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>379729</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>355</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>13293</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>15287</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>408664</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK MEYER</PersonNm>
        <TitleTxt>CFO/TREASURER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>453089</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>26011</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>15000</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>6646</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>500746</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK PEDERSON</PersonNm>
        <TitleTxt>SVP, SITE OPERATIONS</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>272556</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>1025</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>11375</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>10479</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>295435</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK.1" softwareId="23017517" softwareVersionNum="2023v6.0">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CITY OF SAGEVILLE IOWA</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>421331024</BondIssuerEIN>
        <BondIssuedDt>2019-07-10</BondIssuedDt>
        <IssuePriceAmt>10000000</IssuePriceAmt>
        <PurposeDesc>CONSTRUCITON</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>DUBUQUE COUNTY IOWA</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>426004597</BondIssuerEIN>
        <BondIssuedDt>2019-07-10</BondIssuedDt>
        <IssuePriceAmt>10000000</IssuePriceAmt>
        <PurposeDesc>CONSTRUCTION</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CITY OF ASHBURY IOWA</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>420999835</BondIssuerEIN>
        <BondIssuedDt>2019-07-10</BondIssuedDt>
        <IssuePriceAmt>5085000</IssuePriceAmt>
        <PurposeDesc>CONSTRUCTION</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>IOWA FINANCE AUTHORITY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>521699886</BondIssuerEIN>
        <BondIssuedDt>2021-02-04</BondIssuedDt>
        <IssuePriceAmt>35515000</IssuePriceAmt>
        <PurposeDesc>CONSTRUCTION</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>774248</RetiredAmt>
        <TotalProceedsAmt>10000000</TotalProceedsAmt>
        <CapitalExpendituresAmt>10000000</CapitalExpendituresAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>773773</RetiredAmt>
        <TotalProceedsAmt>10000000</TotalProceedsAmt>
        <CapitalExpendituresAmt>10000000</CapitalExpendituresAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>394309</RetiredAmt>
        <TotalProceedsAmt>5085000</TotalProceedsAmt>
        <CapitalExpendituresAmt>5085000</CapitalExpendituresAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <RetiredAmt>548661</RetiredAmt>
        <TotalProceedsAmt>35515000</TotalProceedsAmt>
        <InReserveFundAmt>535406</InReserveFundAmt>
        <CapitalizedInterestAmt>514310</CapitalizedInterestAmt>
        <IssuanceCostsFromProceedsAmt>50001</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>34950689</CapitalExpendituresAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>false</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>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>true</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>true</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>true</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>true</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="23017517" softwareVersionNum="2023v6.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS A MANAGEMENT AGREEMENT WITH PHS MANAGEMENT, LLC (AN AFFILIATE OF PHS), WHEREBY THEY HAVE AUTHORITY AND RESPONSIBILITY FOR THE GENERAL MANAGEMENT OF THE ORGANIZATION, INCLUDING PERSONNEL MANAGEMENT, OPERATING POLICIES, RESIDENT SERVICES, INSURANCE, MAINTENANCE, ACCOUNTING AND OTHER GENERAL MATTERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEMBERS OF THE CORPORATION SHALL BE PRESBYTERIAN HOMES &amp; SERVICES AND SISTERS OF CHARITY OF THE BLESSED VIRGIN MARY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH MEMBER APPOINTS ONE HALF (1/2) OF THE TOTAL NUMBER OF BOARD MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CORPORATION MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT RECEIVING UNANIMOUS MEMBER APPROVAL. (A)INCUR LONG-TERM DEBT;(B)MORTGAGE OR ENCUMBER ANY ASSETS OF THE CORPORATION;(C)SELL, LEASE OR OTHERWISE DISPOSE OF ALL OR SUBSTANTIALLY ALL OF ITS PROPERTY AND ASSETS;(D)VOLUNTARILY DISSOLVE;(E)PURCHASE OR ACQUIRE SUBSTANTIALLY ALL OF THE ASSETS OF ANOTHER ENTITY;(F)MERGE, CONSOLIDATE WITH ANY DOMESTIC OR FOREIGN ORGANIZATION OR LEASE OR SELL MORE THAN FIFTY PERCENT OF THE CORPORATION'S PROPERTY AND ASSETS TO ANY ENTITY IN ANY ONE TRANSACTION OR SERIES OF RELATED TRANSACTIONS;(G)PREPAY ANY INDEBTEDNESS PRIOR TO THE TIME FOR PAYMENT THEREOF AS PROVIDED IN THE CONTRACT EVIDENCING OR CREATING SUCH INDEBTEDNESS;(H)LOAN MONEY OR OTHER ASSETS TO OR GUARANTEE THE OBLIGATIONS OF ANY PERSON OR ENTITY;(I)SUBSTANTIALLY CHANGE THE PRESENT OR NOW INTENDED NATURE OF CORPORATION'S OPEARTIONS;(J)APPROVE ANY EXTRAORDINARY COMPENSATION OR BONUS TO ANY EMPLOYEE;(K)AMEND THE ARTICLES OF INCORPORATION OR BYLAWS;(L)APPROVE, EXTEND OR RENEW ANY CONTRACTS BETWEEN THE CORPORATION AND A MEMBER, OR AN AFFILIATE OF A MEMBER, OR MODIFY ANY SUCH CONTRACTS TO INCREASE THE AMOUNT PAID THEREUNDER BY MORE THAN TEN PERCENT; OR (M)ADMIT ADDITIONAL MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIOR TO FILING WITH THE IRS, THE ORGANIZATION'S FORM 990 IS PROVIDED TO THE GOVERNING BODY OF THE MEMBER THAT CONTROLS MANAGEMENT OF THE ORGANIZATION AND APPOINTS SOME OR ALL DIRECTORS TO THE ORGANIZATION. OFFICERS AND MANAGEMENT OF THE ORGANIZATION HAVE BEEN INVOLVED IN THE PREPARATION OF THE FORM 990 AND REMAIN ACCOUNTABLE TO THE GOVERNING BODY THROUGH REGULAR REVIEW OF FINANCIAL REPORTS AND RELATED INFORMATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION OBTAINS ANNUALLY WRITTEN DISCLOSURES FROM GOVERNING BODY MEMBERS, OFFICERS, AND KEY EMPLOYEES. MANAGEMENT AND OFFICERS REVIEW THESE DISCLOSURES AND EVALUATE WHETHER THE INTEREST COULD RESULT IN A CONFLICT AND THEN TAKE THE NECESSARY STEPS TO REMEDIATE ANY SUCH CONFLICT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBER CONTRIBUTION - BVM = $1500000</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBER CONTRIBUTION - PHS = $1500000</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, SECTION A</FormAndLineReferenceDesc>
        <ExplanationTxt>SHARING OF HOURSOFFICERS &amp; KEY EMPLOYEES SHARE THEIR HOURS BETWEEN THE FILING ORGANIZATION AND ITS RELATED ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="23017517" softwareVersionNum="2023v6.0">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SISTERS OF CHARITY OF THE BLESSED VIRGIN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1100 CARMEL DR</AddressLine1Txt>
          <CityNm>DUBUQUE</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>52003</ZIPCd>
        </USAddress>
        <EIN>420680320</EIN>
        <PrimaryActivitiesTxt>SUPPORT CATHOLIC &amp; SOCIETAL NEEDS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PRESBYTERIAN HOMES AND SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2845 HAMLINE AVE N</AddressLine1Txt>
          <CityNm>ROSEVILLE</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55113</ZIPCd>
        </USAddress>
        <EIN>410758756</EIN>
        <PrimaryActivitiesTxt>SENIOR HOUSING WITH SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <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>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>