<?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>2021-11-12T08:42:38-06:00</ReturnTs>
    <TaxPeriodEndDt>2020-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>382706146</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>YEO &amp; YEO PC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>PO BOX 3275</AddressLine1Txt>
        <CityNm>SAGINAW</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48605</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2020-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>237107569</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>FAMILY HEALTH CENTER INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>FAMI</BusinessNameControlTxt>
      <PhoneNum>2693492641</PhoneNum>
      <USAddress>
        <AddressLine1Txt>117 W PATERSON</AddressLine1Txt>
        <CityNm>KALAMAZOO</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49007</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>DENISE CRAWFORD</PersonNm>
      <PersonTitleTxt>PRESIDENT &amp; CEO</PersonTitleTxt>
      <PhoneNum>2693492641</PhoneNum>
      <SignatureDt>2021-11-07</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>DENISE</PersonFirstNm>
        <PersonLastNm>CRAWFORD</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>BRIAN R DIXON</PreparerPersonNm>
      <PTIN>P01321580</PTIN>
      <PhoneNum>9897939830</PhoneNum>
      <PreparationDt>2021-11-08</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2020</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc5">
      <PrincipalOfficerNm>DENISE CRAWFORD</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>117 W PATERSON</AddressLine1Txt>
        <CityNm>KALAMAZOO</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49007</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>46480856</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.FHCKZOO.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1971</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO ENSURE THAT ALL MEMBERS OF THE COMMUNITY HAVE ACCESS TO QUALITY, COMPREHENSIVE, PATIENT-CENTERED HEALTH CARE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>14</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>14</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>344</TotalEmployeeCnt>
      <TotalVolunteersCnt>14</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>4652103</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>6642535</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>28804891</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>31042687</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>523476</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>509095</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>560953</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>1649943</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>34541423</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>39844260</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>17721720</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>18187831</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>11885665</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>12553143</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>29607385</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>30740974</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>4934038</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>9103286</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>60935075</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>74671676</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>12991653</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>14036090</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>47943422</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>60635586</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>TO ENSURE THAT ALL MEMBERS OF THE COMMUNITY HAVE ACCESS TO QUALITY, COMPREHENSIVE, PATIENT-CENTERED HEALTH CARE.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>23480275</ExpenseAmt>
      <RevenueAmt>32692630</RevenueAmt>
      <Desc>TO PROVIDE QUALITY COMPREHENSIVE PRIMARY CARE TO ALL IN A WELCOMING ENVIRONMENT.</Desc>
      <TotalProgramServiceExpensesAmt>23480275</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc6">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">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc3">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc3">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc3">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc3">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc3">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc3">false</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>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc4">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>56</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>344</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>14</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>14</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>EILEEN CHIANG</PersonNm>
        <PhoneNum>2693492641</PhoneNum>
        <USAddress>
          <AddressLine1Txt>117 W PATERSON</AddressLine1Txt>
          <CityNm>KALAMAZOO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>490072557</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>DENISE CRAWFORD</PersonNm>
        <TitleTxt>PRESIDENT &amp;</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>521269</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20034</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL CLARKE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>332057</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16884</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY GIROLAMI</PersonNm>
        <TitleTxt>NURSE PRACTI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>322855</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>4793</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MAUREEN THOMAS</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>314363</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5806</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EILEEN CHIANG</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>298598</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20043</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EDWARD HAUGHN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>268444</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18884</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID VANSLAMBROUCK</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>249894</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18720</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHY JACKSON</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>249795</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16415</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KENNETH LEPAGE</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>220138</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17514</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CATHY ASH</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>CHRISTINE BEVERLY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERRYSE BROWN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>OLLIE CHAMBERS</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERTO FLACHIER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHERRIE FULLER</PersonNm>
        <TitleTxt>VICE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELEANOR HARRIS</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EFEOSA IDEMUDIA</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AARON LANE-DAVIES</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JACQUELINE LUTTRELL</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS ROHS</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY THORPE</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>PATRICK TROMAN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ADRIAN VAZQUEZ</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2777413</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>139093</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>40</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BE SMITH</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 219241</AddressLine1Txt>
            <CityNm>KANSAS CITY</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>64121</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL</ServicesDesc>
        <CompensationAmt>533117</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WESTPARK COMMUNICATION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>20475 STATE HIGHWAY 249</AddressLine1Txt>
            <CityNm>HOUSTON</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>77070</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT SERVICES</ServicesDesc>
        <CompensationAmt>434305</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BRONSON HEALTHCARE GROUP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>601 JOHN ST</AddressLine1Txt>
            <CityNm>KALAMAZOO</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49007</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL</ServicesDesc>
        <CompensationAmt>396478</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>X-TREME KLEANING KREW</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 3192</AddressLine1Txt>
            <CityNm>KALAMAZOO</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49003</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CLEANING</ServicesDesc>
        <CompensationAmt>273223</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>A1 PHYSICAL THERAPY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2318 GULL ROAD</AddressLine1Txt>
            <CityNm>KALAMAZOO</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49048</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHYS THERAPY</ServicesDesc>
        <CompensationAmt>265370</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>15</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>6526224</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>116311</AllOtherContributionsAmt>
      <NoncashContributionsAmt>18346</NoncashContributionsAmt>
      <TotalContributionsAmt>6642535</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICES REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>31042687</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>31042687</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>31042687</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>385921</TotalRevenueColumnAmt>
        <ExclusionAmt>385921</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>6759770</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>6636596</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>123174</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>123174</TotalRevenueColumnAmt>
        <ExclusionAmt>123174</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>HEALTH PLAN INCENTIVES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1556977</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1556977</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISC REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>92501</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>92501</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MEDICAL RECORDS COPYING</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>465</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>465</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>1649943</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>39844260</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>32692630</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>509095</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1366207</TotalAmt>
        <ProgramServicesAmt>26860</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1339347</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>14060577</TotalAmt>
        <ProgramServicesAmt>12011388</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2049189</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1459037</TotalAmt>
        <ProgramServicesAmt>1060157</ProgramServicesAmt>
        <ManagementAndGeneralAmt>398880</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>246291</TotalAmt>
        <ProgramServicesAmt>205924</ProgramServicesAmt>
        <ManagementAndGeneralAmt>40367</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1055719</TotalAmt>
        <ProgramServicesAmt>830802</ProgramServicesAmt>
        <ManagementAndGeneralAmt>224917</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>73903</TotalAmt>
        <ProgramServicesAmt>1197</ProgramServicesAmt>
        <ManagementAndGeneralAmt>72706</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>55200</TotalAmt>
        <ManagementAndGeneralAmt>55200</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>23102</TotalAmt>
        <ManagementAndGeneralAmt>23102</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>4604520</TotalAmt>
        <ProgramServicesAmt>3029741</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1574779</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>43131</TotalAmt>
        <ProgramServicesAmt>43131</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>193077</TotalAmt>
        <ProgramServicesAmt>48593</ProgramServicesAmt>
        <ManagementAndGeneralAmt>144484</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>276198</TotalAmt>
        <ProgramServicesAmt>219200</ProgramServicesAmt>
        <ManagementAndGeneralAmt>56998</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>327887</TotalAmt>
        <ProgramServicesAmt>246011</ProgramServicesAmt>
        <ManagementAndGeneralAmt>81876</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>42125</TotalAmt>
        <ProgramServicesAmt>10515</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31610</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>399136</TotalAmt>
        <ProgramServicesAmt>305093</ProgramServicesAmt>
        <ManagementAndGeneralAmt>94043</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>978397</TotalAmt>
        <ProgramServicesAmt>747873</ProgramServicesAmt>
        <ManagementAndGeneralAmt>230524</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>103978</TotalAmt>
        <ProgramServicesAmt>79479</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24499</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACY - COST OF GOODS</Desc>
        <TotalAmt>2689116</TotalAmt>
        <ProgramServicesAmt>2689116</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL &amp; DENTAL SUPPLIES</Desc>
        <TotalAmt>1225031</TotalAmt>
        <ProgramServicesAmt>1225031</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EQUIPMENT AND VEHICLES</Desc>
        <TotalAmt>554238</TotalAmt>
        <ProgramServicesAmt>85660</ProgramServicesAmt>
        <ManagementAndGeneralAmt>468578</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES FEES AND DUES</Desc>
        <TotalAmt>443823</TotalAmt>
        <ProgramServicesAmt>281906</ProgramServicesAmt>
        <ManagementAndGeneralAmt>161917</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>520281</TotalAmt>
        <ProgramServicesAmt>332598</ProgramServicesAmt>
        <ManagementAndGeneralAmt>187683</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>30740974</TotalAmt>
        <ProgramServicesAmt>23480275</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7260699</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>6290</BOYAmt>
        <EOYAmt>7890</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>20143449</BOYAmt>
        <EOYAmt>23443793</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>124718</BOYAmt>
        <EOYAmt>1046090</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>5768659</BOYAmt>
        <EOYAmt>7896890</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>682704</BOYAmt>
        <EOYAmt>966475</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>155553</BOYAmt>
        <EOYAmt>219146</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>31861760</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>7125466</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>24415938</BOYAmt>
        <EOYAmt>24736294</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>9267918</BOYAmt>
        <EOYAmt>15261442</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>163109</BOYAmt>
        <EOYAmt>120701</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>206737</BOYAmt>
        <EOYAmt>972955</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>60935075</BOYAmt>
        <EOYAmt>74671676</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>3735670</BOYAmt>
        <EOYAmt>3861934</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>71381</BOYAmt>
        <EOYAmt>49920</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>8073607</BOYAmt>
        <EOYAmt>7766063</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>1110995</BOYAmt>
        <EOYAmt>2358173</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>12991653</BOYAmt>
        <EOYAmt>14036090</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>47599186</BOYAmt>
        <EOYAmt>60436065</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>344236</BOYAmt>
        <EOYAmt>199521</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>47943422</BOYAmt>
        <EOYAmt>60635586</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>60935075</BOYAmt>
        <EOYAmt>74671676</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>9103286</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>505678</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>3083200</OtherChangesInNetAssetsAmt>
      <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="RetDoc6">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>3606058</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4537895</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2949776</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4652103</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>6642535</CurrentTaxYearAmt>
        <TotalAmt>22388367</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>3606058</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4537895</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2949776</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4652103</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>6642535</CurrentTaxYearAmt>
        <TotalAmt>22388367</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>620994</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>21767373</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus3YearsAmt>6632</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>267618</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>554026</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>385921</CurrentTaxYearAmt>
        <TotalAmt>1214197</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>23602564</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>120845372</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.92220</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.96200</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </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">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>905721</OtherCostOrOtherBasisAmt>
        <BookValueAmt>905721</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>27423780</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>5050341</DepreciationAmt>
        <BookValueAmt>22373439</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>524497</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>102187</DepreciationAmt>
        <BookValueAmt>422310</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3007762</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1972938</DepreciationAmt>
        <BookValueAmt>1034824</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>24736294</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>THIRD PARTY COST SETTLEMENTS PAYABLE</Desc>
        <Amt>2358173</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>2358173</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>43410036</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>505678</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>3060098</OtherRevenueAmt>
      <RevenueNotReportedAmt>3565776</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>39844260</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>39844260</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>30717872</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>-23102</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>-23102</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>30740974</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>30740974</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>INVESTMENT FEES -23,102 PPP LOAN REVENUE NOT YET FORGIVEN 3,083,200</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XII, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>INVESTMENT FEES -23,102</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc4">
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <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>DENISE CRAWFORD</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>412730</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>108539</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>7942</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12092</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>541303</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL CLARKE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>242955</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>89102</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>5000</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>11884</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>348941</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KIMBERLY GIROLAMI</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>160151</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>162704</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>1567</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>3226</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>327648</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MAUREEN THOMAS</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>143637</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>170726</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>5806</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>320169</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EILEEN CHIANG</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>238385</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>60213</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>5313</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>14730</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>318641</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EDWARD HAUGHN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>207666</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>60778</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>4367</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>14517</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>287328</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID VANSLAMBROUCK</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <BaseCompensationFilingOrgAmt>173118</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>76776</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>4136</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>14584</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>268614</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATHY JACKSON</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>208977</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>40818</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>4387</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12028</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>266210</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KENNETH LEPAGE</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>176626</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>43512</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>4111</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>13403</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>237652</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS PRESENTED ANNUALLY AT A MONTHLY BOARD MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD MEMBERS ARE REQUIRED TO COMPLETE THE FORM 990 BOARD QUESTIONNAIRE ANNUALLY. THE COMPLETED QUESTIONNAIRES ARE FILED AT FAMILY HEALTH CENTER INC, 117 W PATERSON KALAMAZOO, MI 49007. THE CEO AND CFO MONITOR THE BOARD QUESTIONNAIRES FOR POTENTIAL CONFLICTS. IF ANY CONFLICTS ARISE, THE CEO AND BOARD CHAIR WILL REVIEW AND TAKE APPROPRIATE ACTIONS TO HANDLE THE CONFLICT AND THE BOARD MEMBER WILL ABSTAIN FROM VOTING ON SUCH MATTERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS CONSIDERS THE CEO'S RELEVANT YEARS OF EXPERIENCE, AND ALSO REVIEWS SALARY SURVEY DATA FROM VARIOUS SOURCES SUCH AS MPCA, NACHC AND MGMA. THE SALARY SURVEY REVIEW IS DONE ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CEO CONSIDERS THE OFFICERS' RELEVANT YEARS OF EXPERIENCE, AND ALSO REVIEWS SALARY SURVEY DATA FROM VARIOUS SOURCES SUCH AS MPCA, NACHC AND MGMA. THE SALARY SURVEY REVIEW IS DONE ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICAL &amp; PROF. SERVICES 1,698,097 0 0 OTHER CONTRACTED SERVICES 1,331,644 1,574,779 0 TOTAL 3,029,741 1,574,779 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>INVESTMENT FEES -23,102 PPP LOAN REVENUE NOT YET FORGIVEN 3,083,200 INVESTMENT FEES 23,102 TOTAL 3,083,200</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
