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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA PERRY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL WILLIAMS</PersonNm>
        <TitleTxt>BOARD MEMBER THRU SEPTEMBER 2019</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT MORGAN</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1218825</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>189916</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>6</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WILLIAM F RYAN COMMUNITY HEALTH CENTER</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>110 WEST 97TH STREET</AddressLine1Txt>
            <CityNm>NEW YORK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10025</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ADMIN &amp; SUPPORT SERVICES</ServicesDesc>
        <CompensationAmt>960000</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ST LUKE'S ROOSEVELT HOSPITAL</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>150 EAST 42ND STREET 5TH FLOOR</AddressLine1Txt>
            <CityNm>NEW YORK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10170</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL SERVICES</ServicesDesc>
        <CompensationAmt>383526</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>COMMUNITY EYECARE ASSOCIATES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>229 EAST 79TH STREET</AddressLine1Txt>
            <CityNm>NEW YORK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10021</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EYE CARE SERVICES</ServicesDesc>
        <CompensationAmt>224655</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DENHAM WOLF REAL ESTATE SERVICES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>520 8TH AVENUE</AddressLine1Txt>
            <CityNm>NEW YORK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10018</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>REAL ESTATE CONSULTANTS</ServicesDesc>
        <CompensationAmt>150000</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>COHNREZNICK</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1301 6TH AVENUE</AddressLine1Txt>
            <CityNm>NEW YORK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10019</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>FINANCE CONSULTANTS</ServicesDesc>
        <CompensationAmt>108451</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>8</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>108806</FundraisingAmt>
      <RelatedOrganizationsAmt>406402</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>1684813</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>832425</AllOtherContributionsAmt>
      <NoncashContributionsAmt>216838</NoncashContributionsAmt>
      <TotalContributionsAmt>3032446</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PHARMACY (340B)</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>4596644</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4596644</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>NEW YORK STATE AND CHILD HEALTH</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>3051161</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3051161</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAID MANAGED CARE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>1662817</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1662817</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>1067513</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1067513</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAID MANAGED CARE INCENTIVES</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>671760</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>671760</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>2327212</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2327212</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>13377107</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1291</TotalRevenueColumnAmt>
        <ExclusionAmt>1291</ExclusionAmt>
      </InvestmentIncomeGrp>
      <FundraisingGrossIncomeAmt>17775</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>108806</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>35617</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-17842</TotalRevenueColumnAmt>
        <ExclusionAmt>-17842</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>18975</TotalRevenueColumnAmt>
        <ExclusionAmt>18975</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MEDICAL RECORDS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>728</TotalRevenueColumnAmt>
        <ExclusionAmt>728</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>19703</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>16412705</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13377107</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>3152</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>216838</TotalAmt>
        <ProgramServicesAmt>216838</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>250595</TotalAmt>
        <ProgramServicesAmt>219939</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30656</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>5526786</TotalAmt>
        <ProgramServicesAmt>4816015</ProgramServicesAmt>
        <ManagementAndGeneralAmt>710771</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>389169</TotalAmt>
        <ProgramServicesAmt>350752</ProgramServicesAmt>
        <ManagementAndGeneralAmt>38417</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1222673</TotalAmt>
        <ProgramServicesAmt>1101975</ProgramServicesAmt>
        <ManagementAndGeneralAmt>120698</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>459587</TotalAmt>
        <ProgramServicesAmt>414218</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45369</ManagementAndGeneralAmt>
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      <FeesForServicesManagementGrp>
        <TotalAmt>960000</TotalAmt>
        <ProgramServicesAmt>403200</ProgramServicesAmt>
        <ManagementAndGeneralAmt>556800</ManagementAndGeneralAmt>
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      <FeesForServicesLegalGrp>
        <TotalAmt>82655</TotalAmt>
        <ProgramServicesAmt>23144</ProgramServicesAmt>
        <ManagementAndGeneralAmt>59511</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>53125</TotalAmt>
        <ManagementAndGeneralAmt>53125</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>11238</TotalAmt>
        <FundraisingAmt>11238</FundraisingAmt>
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      <FeesForServicesOtherGrp>
        <TotalAmt>1619530</TotalAmt>
        <ProgramServicesAmt>1276813</ProgramServicesAmt>
        <ManagementAndGeneralAmt>342717</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>33486</TotalAmt>
        <ProgramServicesAmt>16654</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16832</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
        <TotalAmt>316594</TotalAmt>
        <ProgramServicesAmt>219068</ProgramServicesAmt>
        <ManagementAndGeneralAmt>97526</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>142185</ProgramServicesAmt>
        <ManagementAndGeneralAmt>47105</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>40962</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17720</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>15392</TotalAmt>
        <ProgramServicesAmt>11964</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3428</ManagementAndGeneralAmt>
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      <InterestGrp>
        <TotalAmt>85875</TotalAmt>
        <ProgramServicesAmt>68699</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17176</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>290942</ProgramServicesAmt>
        <ManagementAndGeneralAmt>72735</ManagementAndGeneralAmt>
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      <InsuranceGrp>
        <TotalAmt>42219</TotalAmt>
        <ProgramServicesAmt>28626</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13593</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACEUTICALS AND MED</Desc>
        <TotalAmt>2758188</TotalAmt>
        <ProgramServicesAmt>2757008</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1180</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>EQUIP RENTAL AND MAINTE</Desc>
        <TotalAmt>105179</TotalAmt>
        <ProgramServicesAmt>72412</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32767</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>PROGRAM EXPENSE</Desc>
        <TotalAmt>65875</TotalAmt>
        <ProgramServicesAmt>62905</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2970</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT</Desc>
        <TotalAmt>40198</TotalAmt>
        <ProgramServicesAmt>40198</ProgramServicesAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>61124</TotalAmt>
        <ProgramServicesAmt>34015</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27109</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>14927975</TotalAmt>
        <ProgramServicesAmt>12608532</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2308205</ManagementAndGeneralAmt>
        <FundraisingAmt>11238</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>229116</BOYAmt>
        <EOYAmt>2448</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1596068</BOYAmt>
        <EOYAmt>1843459</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>44153</BOYAmt>
        <EOYAmt>257052</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>1443719</BOYAmt>
        <EOYAmt>1373754</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
        <BOYAmt>25751</BOYAmt>
        <EOYAmt>25751</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>71252</BOYAmt>
        <EOYAmt>201345</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>15368101</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>7717170</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>7672130</BOYAmt>
        <EOYAmt>7650931</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>685298</BOYAmt>
        <EOYAmt>739569</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>11767487</BOYAmt>
        <EOYAmt>12094309</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>1691123</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>25000</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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        <EOYAmt>1674702</EOYAmt>
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      <UnsecuredNotesLoansPayableGrp>
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        <EOYAmt>699340</EOYAmt>
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        <EOYAmt>4301381</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>8391546</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2218033</BOYAmt>
        <EOYAmt>3702763</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2218033</BOYAmt>
        <EOYAmt>3702763</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>12094309</EOYAmt>
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      <ReconcilationRevenueExpnssAmt>1484730</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>1991313</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2383750</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2694465</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2840583</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3032446</CurrentTaxYearAmt>
        <TotalAmt>12942557</TotalAmt>
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      <GrossReceiptsAdmissionsGrp>
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        <CurrentTaxYearMinus3YearsAmt>8363781</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10340873</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10699247</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13377107</CurrentTaxYearAmt>
        <TotalAmt>50295348</TotalAmt>
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      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>9505653</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>10747531</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>13035338</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13539830</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>16409553</CurrentTaxYearAmt>
        <TotalAmt>63237905</TotalAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>63237905</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>2205</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1271</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearAmt>1291</CurrentTaxYearAmt>
        <TotalAmt>4767</TotalAmt>
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      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>2205</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1271</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearAmt>1291</CurrentTaxYearAmt>
        <TotalAmt>4767</TotalAmt>
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        <CurrentTaxYearMinus3YearsAmt>306435</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12393</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>66081</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>19703</CurrentTaxYearAmt>
        <TotalAmt>595720</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>9698966</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>11055237</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>13047731</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13605911</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>16430547</CurrentTaxYearAmt>
        <TotalAmt>63838392</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99060</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98760</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00010</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00010</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME - 2015 AMOUNT: $ 187,480. 2016 AMOUNT: $ 303,909. 2017 AMOUNT: $ 10,514. 2018 AMOUNT: $ 64,173. 2019 AMOUNT: $ 18,975. MEDICAL RECORDS - 2015 AMOUNT: $ 3,628. 2016 AMOUNT: $ 2,526. 2017 AMOUNT: $ 1,879. 2018 AMOUNT: $ 1,908. 2019 AMOUNT: $ 728.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <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>
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        <BookValueAmt>1964266</BookValueAmt>
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      <BuildingsGrp>
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        <DepreciationAmt>4424264</DepreciationAmt>
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        <DepreciationAmt>3292906</DepreciationAmt>
        <BookValueAmt>570476</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>7650931</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO WILLIAM F. RYAN COMMUNITY HEALTH CENTER, INC.</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>SUBVENTION CERTIFICATE PAYABLE</Desc>
        <Amt>1600000</Amt>
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      <TotalLiabilityAmt>4301381</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>16361269</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>16361269</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>51436</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>51436</RevenueNotReportedFinclStmtAmt>
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        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE CENTER HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE CENTER IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2016.</ExplanationTxt>
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        <ExplanationTxt>PROVISION FOR BAD DEBT NETTED AGAINST REVENUES 40,198. RECLASS OF PROFESSIONAL FUNDRAISING EXPENSES TO PART IX, LINE 11E 11,238.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
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        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PARTICIPATES IN THE NEW YORK STATE VACCINES FOR CHILDREN PROGRAM, WHICH IS A FEDERALLY-FUNDED PROGRAM THAT PROVIDES VACCINES AT NO COST TO ELIGIBLE CHILDREN. THE VACCINES ARE DISTRIBUTED TO RYAN/CHELSEA-CLINTON AS THE ORGANIZATION IS A REGISTERED VFC PROVIDER. THE ORGANIZATION THEN PROVIDES THE VACCINES TO VFC-ELIGIBLE CHILDREN.</ExplanationTxt>
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        <PersonNm>ERIC WAHL</PersonNm>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>DORM AUTH OF STATE OF NY</BusinessNameLine1Txt>
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        <BondIssuerEIN>146000293</BondIssuerEIN>
        <CUSIPNum>649906RT3</CUSIPNum>
        <BondIssuedDt>2012-02-22</BondIssuedDt>
        <IssuePriceAmt>6279835</IssuePriceAmt>
        <PurposeDesc>REFUND PRIOR ISSUE; 1/13/2000</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
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        <InReserveFundAmt>744686</InReserveFundAmt>
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        <OtherSpentProceedsAmt>5409559</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2012</SubstantialCompletionYr>
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        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>1</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K, PART IV, LINE 2B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOND PROCEEDS HAVE BEEN EXPENDED IN LINE WITH THE EXPENDITURE TEST AND IS NOT SUBJECT TO THE REBATE REQUIREMENT PURSUANT TO IRC SECTION 148.</ExplanationTxt>
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    <IRS990ScheduleM documentId="RetDoc1042900001">
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>216838</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>DONOR VALUED</MethodOfDeterminingRevenuesTxt>
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        <FormAndLineReferenceDesc>PART I, COLUMN (B):</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS REPORTING THE NUMBER OF DONORS IN COLUMN (B).</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>WILLIAM F. RYAN COMMUNITY HEALTH CENTER, INC. PROVIDES GENERAL OVERSIGHT AND FINANCIAL MANAGEMENT SERVICES TO THE ORGANIZATION. SCOTT MORGAN WAS PAID BY WILLIAM F. RYAN COMMUNITY HEALTH CENTER, INC. FOR 2019, HE RECEIVED W-2 COMPENSATION OF $266,527 AND $88,535 OF NON-TAXABLE BENEFITS. WILLIAM F. RYAN COMMUNITY HEALTH CENTER, INC. WAS PAID $960,000 IN 2019 FOR THESE SERVICES.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE DIRECTOR, CHIEF FINANCIAL OFFICER AND CONTROLLER REVIEW THE FORM 990 BEFORE IT IS PRESENTED AND REVIEWED BY THE BOARD OF DIRECTORS. THE CHAIR OF THE FINANCE COMMITTEE THEN PRESENTS THE FORM 990 FOR FULL BOARD REVIEW AT THE BOARD OF DIRECTORS MEETING, BEFORE IT IS FILED WITH THE IRS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>IT IS THE POLICY OF RCC THAT ALL BOARD MEMBERS AND EMPLOYEES DISCLOSE ANY INTEREST REGARDLESS OF WHETHER THE INDIVIDUAL THINKS A CONFLICT OF INTEREST ACTUALLY EXISTS. RCC REQUIRES THAT BOARD MEMBERS, CANDIDATES FOR BOARD MEMBERSHIP, AND EMPLOYEES DISCLOSE ANY CONFLICT OF INTEREST IN WRITING AND UPDATE AT LEAST ANNUALLY. MEMBERS OF THE BOARD AND CANDIDATES FOR MEMBERSHIP ON THE BOARD SHALL MAKE DISCLOSURES IN WRITING TO THE CHAIR OF THE BOARD. IF THE CHAIR HAS SUCH AN INTEREST, HE OR SHE MUST MAKE DISCLOSURE IN WRITING TO THE VICE CHAIR, WHO WILL, IN TURN, BE RESPONSIBLE FOR ADVISING THE BOARD. THE EXECUTIVE DIRECTOR SHALL MAKE DISCLOSURES IN WRITING TO THE CHAIR OF THE BOARD WHO WILL, IN TURN, BE RESPONSIBLE FOR ADVISING THE BOARD OF SUCH DISCLOSURE. EMPLOYEES SHALL MAKE DISCLOSURES IN WRITING TO THE EXECUTIVE DIRECTOR. IN THE CASE OF A POTENTIALLY CONFLICTED PERSON WHO IS A BOARD MEMBER, THAT PERSON MAY MAKE A PRESENTATION TO THE BOARD REGARDING WHETHER HE OR SHE HAS A CONFLICT, AND MAY RESPOND TO RELATED QUESTIONS FROM THE BOARD. HOWEVER, AFTER SUCH PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, OR VOTE ON, WHETHER A CONFLICT OF INTEREST EXISTS, AND IF SUCH CONFLICT IS DETERMINED BY THE BOARD TO EXIST, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, AND VOTING ON, THE TRANSACTION OR ARRANGEMENT THAT INVOLVES THE CONFLICT OF INTEREST. IN THE CASE OF AN EMPLOYEE, THE EXECUTIVE DIRECTOR WILL DECIDE WHETHER A CONFLICT EXISTS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>WHEN DETERMINING COMPENSATION FOR THE EXECUTIVE DIRECTOR, THE ORGANIZATION UTILIZES THE SERVICES OF COMPENSATION CONSULTANTS AND RESEARCHES AND STUDIES THE SALARIES AND FRINGE BENEFITS OF OTHER COMMUNITY HEALTH CENTERS AND HEALTHCARE-RELATED ORGANIZATIONS LOCALLY AND REGIONALLY. DECISIONS AND DELIBERATIONS ARE APPROVED AND DOCUMENTED BY THE BOARD. THIS PROCESS WAS LAST UNDER TAKEN IN 2018.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S FORM 990 AND FORM 1023 ARE AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPE OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, ARTICLES OF INCORPORATION, FORM 990, FORM 1023, AND BY-LAWS ARE ALSO AVAILABLE UPON REQUEST.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER CONTRACTED &amp; PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 143,132. MANAGEMENT AND GENERAL EXPENSES 30,085. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 173,217. PROCESSING FEES: PROGRAM SERVICE EXPENSES 173,808. MANAGEMENT AND GENERAL EXPENSES 48,828. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 222,636. CONSULTANTS: PROGRAM SERVICE EXPENSES 832,290. MANAGEMENT AND GENERAL EXPENSES 247,889. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,080,179. PERSONNEL RECRUITMENT: PROGRAM SERVICE EXPENSES 24,087. MANAGEMENT AND GENERAL EXPENSES 1,310. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,397. FACILITIES SERVICE FEES: PROGRAM SERVICE EXPENSES 22,808. MANAGEMENT AND GENERAL EXPENSES 12,519. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,327. EQUIPMENT SERVICE FEES: PROGRAM SERVICE EXPENSES 25,612. MANAGEMENT AND GENERAL EXPENSES 2,086. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,698. LABORATORY SERVICE FEES: PROGRAM SERVICE EXPENSES 55,076. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,076.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S AUDIT/FINANCE COMMITTEE SHALL BE RESPONSIBLE FOR OVERSEEING THE ACCOUNTING AND FINANCIAL REPORTING PROCESSES OF THE CORPORATION AND THE AUDIT OF THE CORPORATION'S FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AFIA FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PARKWEST FIN STATION PO BOX 20997</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10025</ZIPCd>
        </USAddress>
        <EIN>203957960</EIN>
        <PrimaryActivitiesTxt>TO SUPPORT INITIATIVES THAT PROVIDE HEALTH CARE TO UNDERSERVED POPULATIONS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>