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        <EOYAmt>3300539</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>22792</BOYAmt>
        <EOYAmt>22792</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2871338</BOYAmt>
        <EOYAmt>3323331</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>3045666</BOYAmt>
        <EOYAmt>3368109</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>381609</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>54324</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>16060</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc5">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc3">
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1304086</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>213467</DepreciationAmt>
        <BookValueAmt>1090619</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>390921</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>345309</DepreciationAmt>
        <BookValueAmt>45612</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>30250</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>15863</DepreciationAmt>
        <BookValueAmt>14387</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>1150618</TotalBookValueLandBuildingsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc4">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE A PART I, LINE 3- LE MARS AREA DIALYSIS SERVICES DOES NOT MEET THE DEFINITION OF "HOSPITAL FACILITY" FOR PURPOSE OF THE SCHEDULE H</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 IS PROVIDED TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CENTER REQUIRES BOARD MEMBERS TO DISCLOSE AND REVIEW CONFLICTS OF INTEREST ANNUALLY</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CLINIC MANAGER'S WAGE WAS APPROVED BY THE BOARD AFTER REVIEW OF WAGE AND SALARY DATA RECEIVED FROM FRESENIOUS MEDICAL CARE WHICH IS THE ENTITY THAT PAYS THE STAFF AT THE CENTER</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL APPROPRIATE DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC INCLUDING FORM 990 &amp; FORM 1023 APPLICATIONS DURING NORMAL BUSINESS HOURS AT THE LE MARS AREA DIALYSIS SERVICES OFFICE AT 714 LINCOLN ST NE PO BOX 10, LE MARS, IA 51031</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICAL SUPPLIES 154,769 0 0 MEDICAL WASTE EXPENSE 1,584 0 0 TOTAL 156,353 0 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>UNREALIZED LOSS 16,060</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>