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        <TotalAmt>4819480</TotalAmt>
        <ProgramServicesAmt>4508376</ProgramServicesAmt>
        <ManagementAndGeneralAmt>311104</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>46351</TotalAmt>
        <ProgramServicesAmt>456</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45895</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>378422</TotalAmt>
        <ProgramServicesAmt>354131</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24291</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>750263</TotalAmt>
        <ManagementAndGeneralAmt>750263</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>94515</TotalAmt>
        <ManagementAndGeneralAmt>94515</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>304464</TotalAmt>
        <ManagementAndGeneralAmt>304464</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1668044</TotalAmt>
        <ProgramServicesAmt>1668044</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>91900</TotalAmt>
        <ProgramServicesAmt>87550</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4350</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1204972</TotalAmt>
        <ProgramServicesAmt>1030284</ProgramServicesAmt>
        <ManagementAndGeneralAmt>174688</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>324781</TotalAmt>
        <ProgramServicesAmt>324781</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>139424</TotalAmt>
        <ProgramServicesAmt>23551</ProgramServicesAmt>
        <ManagementAndGeneralAmt>115873</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>1612863</TotalAmt>
        <ProgramServicesAmt>1612863</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>921641</TotalAmt>
        <ProgramServicesAmt>921641</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>612796</TotalAmt>
        <ProgramServicesAmt>514546</ProgramServicesAmt>
        <ManagementAndGeneralAmt>98250</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Dietary food</Desc>
        <TotalAmt>530137</TotalAmt>
        <ProgramServicesAmt>530137</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Equipment rental and ma</Desc>
        <TotalAmt>130884</TotalAmt>
        <ProgramServicesAmt>111526</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19358</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Amortization</Desc>
        <TotalAmt>59996</TotalAmt>
        <ProgramServicesAmt>59996</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Other expenses</Desc>
        <TotalAmt>50196</TotalAmt>
        <ProgramServicesAmt>3475</ProgramServicesAmt>
        <ManagementAndGeneralAmt>46721</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>10698</TotalAmt>
        <ProgramServicesAmt>10698</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>13751827</TotalAmt>
        <ProgramServicesAmt>11762055</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1989772</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>1731202</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>124977</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>1011084</BOYAmt>
        <EOYAmt>1074396</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>58423</BOYAmt>
        <EOYAmt>54363</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>97173</BOYAmt>
        <EOYAmt>96300</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>28608211</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>10944128</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>18262968</BOYAmt>
        <EOYAmt>17664083</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>6419275</BOYAmt>
        <EOYAmt>6489964</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>27698410</BOYAmt>
        <EOYAmt>27235285</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>793321</BOYAmt>
        <EOYAmt>907450</EOYAmt>
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      <DeferredRevenueGrp>
        <BOYAmt>72931</BOYAmt>
        <EOYAmt>134000</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>28760000</BOYAmt>
        <EOYAmt>28375000</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>848244</BOYAmt>
        <EOYAmt>833494</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>30474496</BOYAmt>
        <EOYAmt>30249944</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>-2776086</BOYAmt>
        <EOYAmt>-3014659</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>-2776086</BOYAmt>
        <EOYAmt>-3014659</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>27698410</BOYAmt>
        <EOYAmt>27235285</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-238573</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus1YearAmt>700</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>288</CurrentTaxYearAmt>
        <TotalAmt>988</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>12239655</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>13186802</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12798046</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13557538</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13613353</CurrentTaxYearAmt>
        <TotalAmt>65395394</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>12239655</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>13186802</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12798046</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13558238</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13613641</CurrentTaxYearAmt>
        <TotalAmt>65396382</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>65396382</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>375515</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>365831</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>351732</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>67834</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12842</CurrentTaxYearAmt>
        <TotalAmt>1173754</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>375515</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>365831</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>351732</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>67834</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12842</CurrentTaxYearAmt>
        <TotalAmt>1173754</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>12615170</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>13552633</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>13149778</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13626072</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13626483</CurrentTaxYearAmt>
        <TotalAmt>66570136</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98240</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.97660</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01760</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.02340</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>660000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>660000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>21811336</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>7342571</DepreciationAmt>
        <BookValueAmt>14468765</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3627936</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1996374</DepreciationAmt>
        <BookValueAmt>1631562</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>2508939</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1605183</DepreciationAmt>
        <BookValueAmt>903756</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>17664083</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Accrued interest receivable</Desc>
        <BookValueAmt>872</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Insurance escrow</Desc>
        <BookValueAmt>98463</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Bond funds</Desc>
        <BookValueAmt>3845593</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Replacement reserve account</Desc>
        <BookValueAmt>1002612</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Tenant/patient funds held in trust</Desc>
        <BookValueAmt>1094</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Deferred loan costs and capitalized - net of amortization</Desc>
        <BookValueAmt>1541330</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>6489964</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Security deposits</Desc>
        <Amt>28750</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Accrued interest</Desc>
        <Amt>803750</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Tenant/patient funds held in trust</Desc>
        <Amt>994</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>833494</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>13626195</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>13626195</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>-112941</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-112941</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>13513254</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>13864768</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>13864768</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>-112941</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>-112941</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>13751827</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Company is exempt from taxation as a nonprofit organization in accordance with 501(c)(3) of the Internal Revenue Code. The Company adopted the recognition requirements for uncertain income tax positions as required by Financial Accounting Standards Board Accounting Standards Codification (FASB ASC) 740-10 (formerly known as FASB Interpretation No. 48, Accounting for Uncertainty in Income Taxes), with no cumulative effect adjustment required. Income tax benefits are recognized for income tax positions taken or expected to be taken in a tax return, only when it is determined that the income tax position will more-likely-than-not be sustained upon examination by taxing authorities. The Company has analyzed tax positions taken for filing with the Internal Revenue Service and the state jurisdiction where it operates. The Company believes that income tax filing positions will be sustained upon examination and does not anticipate any adjustments that would result in a material adverse effect on the Company's financial condition, results of operations, or cash flows. Accordingly, the Company has not recorded any reserves or related accruals for interest and penalties for uncertain income tax positions at December 31, 2014. The Company is subject to routine audits by taxing jurisdictions; however, there are currently no audits in progress for any open tax periods. The Company's open audit periods are the years ended December 31, 2011, 2012, and 2013.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Charitable contribution revenue netted with expense 288. Loss on disposal of property and equipment -113,229.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Charitable contribution revenue netted with expense 288. Loss on disposal of property and equipment -113,229.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>The Industrial Development Authority of the City of Flagstaff Arizona</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>521293802</BondIssuerEIN>
        <CUSIPNum>338448AG8</CUSIPNum>
        <BondIssuedDt>2007-08-01</BondIssuedDt>
        <IssuePriceAmt>30650000</IssuePriceAmt>
        <PurposeDesc>Refinance real estate used by organization</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>2275000</RetiredAmt>
        <TotalProceedsAmt>30650000</TotalProceedsAmt>
        <InReserveFundAmt>2050428</InReserveFundAmt>
        <RefundingEscrowAmt>6866968</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>610673</IssuanceCostsFromProceedsAmt>
        <WorkingCapitalExpendituresAmt>797387</WorkingCapitalExpendituresAmt>
        <OtherSpentProceedsAmt>20324544</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2007</SubstantialCompletionYr>
        <CurrentRefundingInd>0</CurrentRefundingInd>
        <AdvanceRefundingInd>1</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>1</Form8038TFiledInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is prepared by an independent certified public accounting firm. It is then reviewed by the controller and CPAs of the management company. The Form 990 is given to each Board member in advance of a scheduled meeting of the Board for their review. There is discussion of the Form 990 at the Board meeting with the preparers and the management company's representative prior to Board approval of the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Each member of the governing board annually completes a disclosure of conflict of interest questionnaire.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation is based on experience and market salary surveys, and is reviewed annually.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes it governing documents, conflict of interest policy, and financial statements available to the public upon written request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>General medical services : Program service expenses 72,025. Management and general expenses 0. Fundraising expenses 0. Total expenses 72,025. Nursing and therapy : Program service expenses 1,371,395. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,371,395. Dining, laundry, and housekeeping : Program service expenses 69,126. Management and general expenses 0. Fundraising expenses 0. Total expenses 69,126. Other : Program service expenses 155,498. Management and general expenses 0. Fundraising expenses 0. Total expenses 155,498.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>The financial statements are prepared by an independent accounting firm. The statements are reviewed and approved by the board before being issued. This process was the same as last year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>RELATED ORGANIZATION COMPENSATION:</FormAndLineReferenceDesc>
        <ExplanationTxt>Made an effort to obtain information on compensation, if any were paid from a related organization. No other compensation or transactions were noted other than those listed on Form 990, Part VII, Line 1a.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>