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        <ManagementAndGeneralAmt>1222</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>16283</TotalAmt>
        <ProgramServicesAmt>12375</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3908</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>10484</TotalAmt>
        <ProgramServicesAmt>7968</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2516</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>106635</TotalAmt>
        <ProgramServicesAmt>81043</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25592</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>14450</TotalAmt>
        <ProgramServicesAmt>10982</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3468</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>248042</TotalAmt>
        <ProgramServicesAmt>188512</ProgramServicesAmt>
        <ManagementAndGeneralAmt>59530</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>121683</TotalAmt>
        <ProgramServicesAmt>92479</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29204</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>49416</TotalAmt>
        <ProgramServicesAmt>37556</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11860</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>188977</TotalAmt>
        <ProgramServicesAmt>143623</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45354</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>3032</TotalAmt>
        <ProgramServicesAmt>2304</ProgramServicesAmt>
        <ManagementAndGeneralAmt>728</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>0</TotalAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>64362</TotalAmt>
        <ProgramServicesAmt>48915</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15447</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>81017</TotalAmt>
        <ProgramServicesAmt>61573</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19444</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>86427</TotalAmt>
        <ProgramServicesAmt>65685</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20742</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>5804722</TotalAmt>
        <ProgramServicesAmt>4413348</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1391374</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>599403</BOYAmt>
        <EOYAmt>352493</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>410972</BOYAmt>
        <EOYAmt>417181</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>490390</BOYAmt>
        <EOYAmt>346700</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>511846</BOYAmt>
        <EOYAmt>498744</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>560785</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>240890</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>320709</BOYAmt>
        <EOYAmt>319895</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>1640958</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>0</EOYAmt>
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      <InvestmentsProgramRelatedGrp>
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        <EOYAmt>0</EOYAmt>
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      <IntangibleAssetsGrp>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>795</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>3576766</EOYAmt>
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        <EOYAmt>500131</EOYAmt>
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      <GrantsPayableGrp>
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        <EOYAmt>0</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>0</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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        <EOYAmt>0</EOYAmt>
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      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>489046</BOYAmt>
        <EOYAmt>500131</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowSFAS117Ind>X</OrgDoesNotFollowSFAS117Ind>
      <CapStkTrPrinCurrentFundsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </CapStkTrPrinCurrentFundsGrp>
      <PdInCapSrplsLandBldgEqpFundGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PdInCapSrplsLandBldgEqpFundGrp>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>3020941</BOYAmt>
        <EOYAmt>3076635</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>3020941</BOYAmt>
        <EOYAmt>3076635</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>3509987</BOYAmt>
        <EOYAmt>3576766</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>14238</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>41456</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>720</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>720</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>4527652</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4892628</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4410132</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4930346</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5682657</CurrentTaxYearAmt>
        <TotalAmt>24443415</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <TotalAmt>0</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <GovtFurnSrvcFcltsVl509Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>4528372</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4892628</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4410132</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4930346</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5682657</CurrentTaxYearAmt>
        <TotalAmt>24444135</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
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        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>24444135</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>64960</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>38306</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>149330</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>104426</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>133471</CurrentTaxYearAmt>
        <TotalAmt>490493</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <TotalAmt>0</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>64960</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>38306</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>149330</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>104426</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>133471</CurrentTaxYearAmt>
        <TotalAmt>490493</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <TotalAmt>0</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>685</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>716</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>883</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>477</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2832</CurrentTaxYearAmt>
        <TotalAmt>5593</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>4594017</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4931650</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4560345</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5035249</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5818960</CurrentTaxYearAmt>
        <TotalAmt>24940221</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98011</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98277</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01967</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01709</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbyingGrp />
      <TotalDirectLobbyingGrp />
      <TotalLobbyingExpendGrp />
      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>true</GrantsOtherOrganizationsInd>
      <GrantsOtherOrganizationsAmt>322</GrantsOtherOrganizationsAmt>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>false</OtherActivitiesInd>
      <TotalLobbyingExpendituresAmt>322</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp />
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>177828</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>62240</DepreciationAmt>
        <BookValueAmt>115588</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>101243</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>48330</DepreciationAmt>
        <BookValueAmt>52913</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>281714</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>130320</DepreciationAmt>
        <BookValueAmt>151394</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp />
      <TotalBookValueLandBuildingsAmt>319895</TotalBookValueLandBuildingsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="IRS990ScheduleI">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>HOME HEALTH SERVICES</GrantTypeTxt>
        <RecipientCnt>3</RecipientCnt>
        <NonCashAssistanceAmt>4675</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>STD CHARGE FOR SERV</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>HOME HEALTH CARE</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>HOLIDAY TURKEYS</GrantTypeTxt>
        <RecipientCnt>12</RecipientCnt>
        <NonCashAssistanceAmt>257</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>COST</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>GIFT CERTIFICATES</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>BATH AIDE EQUIPMENT</GrantTypeTxt>
        <RecipientCnt>22</RecipientCnt>
        <NonCashAssistanceAmt>2392</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>2 X COST</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>BATH AIDE EQUIPMENT</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PART IV</FormAndLineReferenceDesc>
        <ExplanationTxt>The fund is used to provide Home Health services to patients that have no insurance and are unable to pay for services. At the time of referral we verify insurance. If we determine the potential referral has no insurance coverage, then we determine whether or not to accept the referral. If we decide to accept the referral with the condition of no insurance and the patient has indicated that they do not have the means to pay for services, then we open the patient under the "Indigent Account". This fund is also used to provide certain Durable Medical Equipment to people of the community that demonstrate a financial hardship. The equipment provided (usually bath aide equipment) is typically not covered by insurance. Our social worker makes the determination if the person demonstrates a financial hardship and then arranges for the delivery of the equipment.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>SEE SCHEDULE L PART V</PersonNm>
        </NameOfInterested>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE L, PART IV</FormAndLineReferenceDesc>
        <ExplanationTxt>A) STEFANIE APPL B) STEFANIE APPL IS THE WIFE OF CORY APPL, THE ADMINISTRATOR/DIRECTOR OF SPECTRUM HEALTH FOUNDATION, INC. AND THE DAUGHTER-IN-LAW OF MARILYN APPL, THE SECRETARY/TREASURER/DIRECTOR OF SPECTRUM HEALTH FOUNDATION, INC. C) $71,287.22 D) STEFANIE APPL IS AN EMPLOYEE OF SPECTRUM HEALTH FOUNDATION, INC. E) NO</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>MARILYN APPL AND CORY APPL HAVE A FAMILY RELATIONSHIP WITH EACH OTHER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ACCOUNTING PERSONNEL. ANY QUESTIONS OR CONCERNS THAT THE ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND CLARIFICATIONS OR CORRECTIONS THAT NEED TO BE MADE ARE MADE. A COPY OF THE 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD. ANY QUESTIONS OR CONCERNS THAT THE VOTING BOARD MEMBERS HAVE ARE ADDRESSED AND CLARIFICATIONS OR CORRECTIONS THAT NEED TO BE MADE ARE MADE. AT THIS POINT THE 990 IS CONSIDERED FINAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>TO AVOID POSSIBLE CONFLICTS OF INTEREST, THE FOLLOWING WILL BE ADHERED TO BY THE ADMINISTRATION, BOARD OF DIRECTORS, GOVERNING BOARD MEMBERS AND FULL-TIME STAFF: 1) CAN NOT BE EMPLOYED BY OR CONSULT WITH ANOTHER HOME CARE AGENCY; 2) MUST KEEP STRATEGIC DOCUMENTS CONFIDENTIAL; 3) MUST REVIEW AND SIGN THE AGENCY CONFLICT OF INTEREST POLICY ANNUALLY. IF A CONFLICT OF INTEREST DOES ARISE, THE INDIVIDUAL(S) WITH THE CONFLICT OF INTEREST WILL LEAVE THE ROOM AND ABSTAIN FROM VOTING ON THAT PARTICULAR ISSUE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINES 15A &amp; B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE OFFICERS' COMPENSATION WAS REVIEWED BY THE INDEPENDENT MEMBERS OF THE BOARD DURING 2011. ALSO, A COMPENSATION STUDY WAS REVIEWED DURING 2011. THE ORGANIZATION DOCUMENTED THE DECISIONS OF THE BOARD MEMBERS REGARDING THE OFFICERS' COMPENSATION ARRANGEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>