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      <FeesForServicesAccountingGrp>
        <TotalAmt>29535</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29535</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForServicesOtherGrp>
        <TotalAmt>52377</TotalAmt>
        <ProgramServicesAmt>47101</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5276</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <AdvertisingGrp>
        <TotalAmt>5254</TotalAmt>
        <ProgramServicesAmt>1770</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3484</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>90274</TotalAmt>
        <ProgramServicesAmt>33614</ProgramServicesAmt>
        <ManagementAndGeneralAmt>56660</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <InformationTechnologyGrp>
        <TotalAmt>131925</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>131925</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OccupancyGrp>
        <TotalAmt>92045</TotalAmt>
        <ProgramServicesAmt>32708</ProgramServicesAmt>
        <ManagementAndGeneralAmt>59337</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <TravelGrp>
        <TotalAmt>64932</TotalAmt>
        <ProgramServicesAmt>35835</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29097</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>25352</TotalAmt>
        <ProgramServicesAmt>16022</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9330</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <InterestGrp>
        <TotalAmt>1235</TotalAmt>
        <ProgramServicesAmt>1235</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <DepreciationDepletionGrp>
        <TotalAmt>136825</TotalAmt>
        <ProgramServicesAmt>93506</ProgramServicesAmt>
        <ManagementAndGeneralAmt>43319</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>31194</TotalAmt>
        <ProgramServicesAmt>25755</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5439</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Maintenance/Repai</Desc>
        <TotalAmt>48359</TotalAmt>
        <ProgramServicesAmt>35204</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13155</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Other</Desc>
        <TotalAmt>48691</TotalAmt>
        <ProgramServicesAmt>19736</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28955</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>Patient Care Services</Desc>
        <TotalAmt>316661</TotalAmt>
        <ProgramServicesAmt>316661</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Supplies</Desc>
        <TotalAmt>353798</TotalAmt>
        <ProgramServicesAmt>301044</ProgramServicesAmt>
        <ManagementAndGeneralAmt>52754</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>5353496</TotalAmt>
        <ProgramServicesAmt>3622769</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1730727</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1885271</BOYAmt>
        <EOYAmt>1755555</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>94661</BOYAmt>
        <EOYAmt>111239</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>244097</BOYAmt>
        <EOYAmt>416140</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>1877</BOYAmt>
        <EOYAmt>195</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>40036</BOYAmt>
        <EOYAmt>89816</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>39240</BOYAmt>
        <EOYAmt>4860</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>4539917</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2352671</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>2168236</BOYAmt>
        <EOYAmt>2187246</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>4473418</BOYAmt>
        <EOYAmt>4565051</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>335068</BOYAmt>
        <EOYAmt>300341</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>335068</BOYAmt>
        <EOYAmt>300341</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>4138350</BOYAmt>
        <EOYAmt>4264710</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>4138350</BOYAmt>
        <EOYAmt>4264710</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>4473418</BOYAmt>
        <EOYAmt>4565051</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>127958</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>-1598</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>false</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="00000002" softwareId="17005306">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>5348504</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4852125</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5182634</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5465080</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5406197</CurrentTaxYearAmt>
        <TotalAmt>26254540</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>5348504</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4852125</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5182634</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5465080</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5406197</CurrentTaxYearAmt>
        <TotalAmt>26254540</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>26254540</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>2327</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2178</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2725</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3604</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4056</CurrentTaxYearAmt>
        <TotalAmt>14890</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>19554</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>69376</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>107897</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>90121</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>71201</CurrentTaxYearAmt>
        <TotalAmt>358149</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>26627579</TotalSupportAmt>
      <PublicSupportCY170Pct>0.98600</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.98300</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <PublicSupportTotal509Amt>0</PublicSupportTotal509Amt>
      <PublicSupportCY509Pct>0</PublicSupportCY509Pct>
      <InvestmentIncomeCYPct>0</InvestmentIncomeCYPct>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Pt II Ln 10</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Income Part II, Line 10 Description: Other Income 2013: 19554. 2014: 69376. 2015: 107897. 2016: 90121. 2017: 71201.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="00000003" softwareId="17005306">
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>3325528</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1482572</DepreciationAmt>
        <BookValueAmt>1842956</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1126951</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>804340</DepreciationAmt>
        <BookValueAmt>322611</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>87438</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>65759</DepreciationAmt>
        <BookValueAmt>21679</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>2187246</TotalBookValueLandBuildingsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>5481454</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>5481454</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>5481454</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>5353496</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>5353496</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>5353496</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="00000004" softwareId="17005306">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Chief Financial Officer reviews the Form 990 in its entirety before signing. The Form 990 will be presented to the Board of Directors as well for their review.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Through training, emails, letters, and disciplinary measures when violations occur</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>Through the National Association of Community Health Centers benefits and yearly surveys in the area.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Through Board of Directors meetings which are open to the public.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization has Board Members are the governing body that provides oversight of management decisions</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>Through the National Association of Community Health Centers benefits and yearly surveys in the area.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XI</FormAndLineReferenceDesc>
        <ExplanationTxt>Line 9 Loss on Disposition of Fixed Assets.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>