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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1073410</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>114737</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>6</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <GovernmentGrantsAmt>2859534</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>12000</AllOtherContributionsAmt>
      <NoncashContributionsAmt>12000</NoncashContributionsAmt>
      <TotalContributionsAmt>2871534</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICES</Desc>
        <TotalRevenueColumnAmt>4384109</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4384109</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>4384109</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>48953</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>48953</RelatedOrExemptFuncIncomeAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>4500</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>6000</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>-1500</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-1500</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-1500</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER INCOME</Desc>
        <TotalRevenueColumnAmt>10120</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10120</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>10120</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>7313216</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4441682</RelatedOrExemptFuncIncomeAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>4049708</TotalAmt>
        <ProgramServicesAmt>3587691</ProgramServicesAmt>
        <ManagementAndGeneralAmt>462017</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>169985</TotalAmt>
        <ProgramServicesAmt>144900</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25085</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>363742</TotalAmt>
        <ProgramServicesAmt>317253</ProgramServicesAmt>
        <ManagementAndGeneralAmt>46489</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>256579</TotalAmt>
        <ProgramServicesAmt>223942</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32637</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>1688</TotalAmt>
        <ManagementAndGeneralAmt>1688</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>20241</TotalAmt>
        <ManagementAndGeneralAmt>20241</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <AdvertisingGrp>
        <TotalAmt>15974</TotalAmt>
        <ProgramServicesAmt>11131</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4843</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>66755</TotalAmt>
        <ProgramServicesAmt>41557</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25198</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>195885</TotalAmt>
        <ProgramServicesAmt>128191</ProgramServicesAmt>
        <ManagementAndGeneralAmt>67694</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>44488</TotalAmt>
        <ProgramServicesAmt>29958</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14530</ManagementAndGeneralAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>272536</TotalAmt>
        <ProgramServicesAmt>192812</ProgramServicesAmt>
        <ManagementAndGeneralAmt>79724</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>25135</TotalAmt>
        <ProgramServicesAmt>13432</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11703</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>602435</TotalAmt>
        <ProgramServicesAmt>561207</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41228</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CONTRACTUAL SERVICES</Desc>
        <TotalAmt>589046</TotalAmt>
        <ProgramServicesAmt>273382</ProgramServicesAmt>
        <ManagementAndGeneralAmt>315664</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>162045</TotalAmt>
        <ProgramServicesAmt>129443</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32602</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TELEPHONE</Desc>
        <TotalAmt>83683</TotalAmt>
        <ProgramServicesAmt>71507</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12176</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>110220</TotalAmt>
        <ProgramServicesAmt>66981</ProgramServicesAmt>
        <ManagementAndGeneralAmt>43239</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>7030145</TotalAmt>
        <ProgramServicesAmt>5793387</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1236758</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>337704</BOYAmt>
        <EOYAmt>495628</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>2255383</BOYAmt>
        <EOYAmt>2528989</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>30956</BOYAmt>
        <EOYAmt>50565</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>291635</BOYAmt>
        <EOYAmt>363448</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>19000</BOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>14167</BOYAmt>
        <EOYAmt>20581</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>121655</BOYAmt>
        <EOYAmt>76889</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>5393175</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2055499</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>3496663</BOYAmt>
        <EOYAmt>3337676</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>4500</BOYAmt>
        <EOYAmt>9200</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <TotalAssetsGrp>
        <BOYAmt>6571663</BOYAmt>
        <EOYAmt>6882976</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>596737</BOYAmt>
        <EOYAmt>624979</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>596737</BOYAmt>
        <EOYAmt>624979</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>5974926</BOYAmt>
        <EOYAmt>6257997</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>5974926</BOYAmt>
        <EOYAmt>6257997</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>6571663</BOYAmt>
        <EOYAmt>6882976</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>283071</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <AuditCommitteeInd>false</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc7">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>2253051</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2448972</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2422912</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2535144</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2871534</CurrentTaxYearAmt>
        <TotalAmt>12531613</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>2253051</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2448972</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2422912</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2535144</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2871534</CurrentTaxYearAmt>
        <TotalAmt>12531613</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>12531613</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>5041</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4850</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5562</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>31660</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>48953</CurrentTaxYearAmt>
        <TotalAmt>96066</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>12627679</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>4443182</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.99240</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99590</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc3">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>181084</OtherCostOrOtherBasisAmt>
        <BookValueAmt>181084</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>3288083</OtherCostOrOtherBasisAmt>
        <BookValueAmt>3288083</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>623658</OtherCostOrOtherBasisAmt>
        <BookValueAmt>623658</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1271261</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2055499</DepreciationAmt>
        <BookValueAmt>-784238</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>29089</OtherCostOrOtherBasisAmt>
        <BookValueAmt>29089</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>3337676</TotalBookValueLandBuildingsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>7313216</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>7313216</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>7313216</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>7030145</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>7030145</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>7030145</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc4">
      <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>KEVIN KOEHLER</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>217810</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>27533</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>245343</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES MONROE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>219447</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>24926</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>244373</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NEIL WANEE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>217074</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>17633</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>234707</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc5">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>KENNETH SUMERFORD</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SPOUSE OF ED</RelationshipDescriptionTxt>
        <TransactionAmt>7200</TransactionAmt>
        <TransactionDesc>OFFICE RENT</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE L, PART V</FormAndLineReferenceDesc>
        <ExplanationTxt>KENNETH SUMERFORD IS THE SPOUSE OF THE EXECUTIVE DIRECTOR. THE ORGANIZATION RENTS OFFICE SPACE FROM MR SUMERFORD.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc6">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE DIRECTOR OF FINANCE AND EXECUTIVE DIRECTOR REVIEW THE 990 AND PRESENT THE RESULTS TO THE BOARD OF DIRECTORS FOR REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY AT THE ANNUAL MEETING IN JUNE. WHEN A CONFLICT OF INTEREST IS DISCLOSED, THE BOARD MEMBER MUST RESIGN IF IT IS IN CONFLICT WITH THE BOARD'S BYLAWS. THE ORGANIZATION ALSO HAS A COMPLIANCE OFFICER THAT MONITORS COMPLIANCE WITH THE VARIOUS PROGRAMS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION OF TOP MANAGEEMNT POSITIONS IS SET BY THE BOARD AND REVIEWED ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION OF OTHER OFFICERS AND KEY POSITIONS IS SET BY THE BOARD AND REVIEWED ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PUBLIC DOCUMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>