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        <TotalRevenueColumn>15643331</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>15465036</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>132047</ExclusionAmount>
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      <GrantsToDomesticOrgs>
        <Total>0</Total>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>283953</Total>
        <ManagementAndGeneral>283953</ManagementAndGeneral>
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      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>6586770</Total>
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        <ManagementAndGeneral>650474</ManagementAndGeneral>
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      <PensionPlanContributions>
        <Total>90788</Total>
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        <ManagementAndGeneral>9079</ManagementAndGeneral>
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      <OtherEmployeeBenefits>
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        <ManagementAndGeneral>61185</ManagementAndGeneral>
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        <ManagementAndGeneral>76884</ManagementAndGeneral>
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      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
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        <ManagementAndGeneral>100999</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>0</Total>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
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      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
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        <ProgramServices>14613</ProgramServices>
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        <ManagementAndGeneral>8239</ManagementAndGeneral>
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      <InformationTechnology>
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      </InformationTechnology>
      <Royalties>
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      </Royalties>
      <Occupancy>
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      <Travel>
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      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
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      <ConferencesMeetings>
        <Total>0</Total>
      </ConferencesMeetings>
      <Interest>
        <Total>0</Total>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>156468</Total>
        <ProgramServices>148645</ProgramServices>
        <ManagementAndGeneral>7823</ManagementAndGeneral>
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        <ManagementAndGeneral>17697</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>MEDICAL SUPPLIES</Description>
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        <ManagementAndGeneral>11248</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>MEDICAL SERVICES</Description>
        <Total>978067</Total>
        <ProgramServices>977486</ProgramServices>
        <ManagementAndGeneral>581</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>STATE FRANCHISE FEES</Description>
        <Total>608165</Total>
        <ProgramServices>608165</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>REPAIRS AND MAINTENANCE</Description>
        <Total>218440</Total>
        <ProgramServices>164120</ProgramServices>
        <ManagementAndGeneral>54320</ManagementAndGeneral>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>272135</Total>
        <ProgramServices>254615</ProgramServices>
        <ManagementAndGeneral>17520</ManagementAndGeneral>
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      <TotalFunctionalExpenses>
        <Total>13051502</Total>
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        <ManagementAndGeneral>1448096</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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      <CashNonInterestBearing>
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        <EOY>2221250</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
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        <EOY>0</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
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        <EOY>0</EOY>
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        <EOY>0</EOY>
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        <EOY>0</EOY>
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        <EOY>213369</EOY>
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        <EOY>0</EOY>
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      </LoansFromOfficersDirectors>
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        <EOY>0</EOY>
      </MortNotesPyblSecuredInvestProp>
      <UnsecuredNotesLoansPayable>
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        <EOY>0</EOY>
      </UnsecuredNotesLoansPayable>
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        <BOY>332900</BOY>
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      <TotalLiabilities>
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      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
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        <EOY>0</EOY>
      </PermanentlyRestrictedNetAssets>
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        <EOY>11191110</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
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        <EOY>12700641</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>2591829</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>-147474</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
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      <PubliclySupportedOrg509a2>X</PubliclySupportedOrg509a2>
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        <CurrentTaxYearMinus3Years>153055</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>1600</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>1805</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>46248</CurrentTaxYear>
        <Total>322769</Total>
      </GiftsGrantsContribReceived509>
      <GrossReceiptsFromAdmissions>
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        <CurrentTaxYearMinus3Years>14284463</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>14632361</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>15250241</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>15412507</CurrentTaxYear>
        <Total>73526525</Total>
      </GrossReceiptsFromAdmissions>
      <Total509>
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        <CurrentTaxYearMinus3Years>14437518</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>14633961</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>15252046</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>15458755</CurrentTaxYear>
        <Total>73849294</Total>
      </Total509>
      <PublicSupportTotal509>73849294</PublicSupportTotal509>
      <GrossInvestmentIncome509>
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        <CurrentTaxYearMinus3Years>31700</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>39798</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>66335</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>114987</CurrentTaxYear>
        <Total>428358</Total>
      </GrossInvestmentIncome509>
      <InvestmentIncomeAndUBTI>
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        <CurrentTaxYearMinus3Years>31700</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>39798</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>66335</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>114987</CurrentTaxYear>
        <Total>428358</Total>
      </InvestmentIncomeAndUBTI>
      <OtherIncome509>
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        <CurrentTaxYearMinus1Year>303424</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>52529</CurrentTaxYear>
        <Total>358520</Total>
      </OtherIncome509>
      <TotalSupportTotal>
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        <CurrentTaxYearMinus1Year>15621805</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>15626271</CurrentTaxYear>
        <Total>74636172</Total>
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      <PublicSupportPercentage509>0.98946</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.98948</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0.00574</InvestmentIncomePercentage>
      <PriorYrInvestIncomePercentage>0.00631</PriorYrInvestIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <CurrentYearMinus3Years />
      <Land />
      <Buildings />
      <LeaseholdImprovements />
      <Equipment>
        <OtherCostOrOtherBasis>239226</OtherCostOrOtherBasis>
        <Depreciation>142371</Depreciation>
        <BookValue>96855</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>1382320</OtherCostOrOtherBasis>
        <Depreciation>781030</Depreciation>
        <BookValue>601290</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>698145</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>EST SETTLEMENT - THIRD PARTY</Description>
        <BookValue>56210</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>RELATED PARTY RECEIVABLE</Description>
        <BookValue>4906865</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>PATIENT FUNDS</Description>
        <BookValue>10955</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>ASSETS LIMITED TO USE</Description>
        <BookValue>16037</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>4990067</TotalBookValueOtherAssets>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>DEPOSITS</Description>
        <Amount>135900</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>EST SETTLEMENT - THIRD PARTY</Description>
        <Amount>6578</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>142478</TotalOfAmounts>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationCommittee>X</CompensationCommittee>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>PAUL PSOTA</NamePerson>
        <BaseCompensationFilingOrg>135027</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>13220</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>10837</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>159084</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>participate in, receive payment from, supplemental nonqualified retirement</Identifier>
        <ReturnReference>schedule j, part i, #4b</ReturnReference>
        <Explanation>Current CEO is a participant in the organization's nonqualified deferred compensation plan. Contribution amounted to $7,677.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>john kedzior</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>board director</Relationship>
        <AmountOfTransaction>54466</AmountOfTransaction>
        <DescriptionOfTransaction>legal services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>david knowles</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>board director</Relationship>
        <AmountOfTransaction>54466</AmountOfTransaction>
        <DescriptionOfTransaction>legal services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>JEFF WARNKIN</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>BOARD DIRECTOR</Relationship>
        <AmountOfTransaction>14613</AmountOfTransaction>
        <DescriptionOfTransaction>INVESTMENT SERVICES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>MEMBER CLASSES</Identifier>
        <ReturnReference>PAGE 6, PART VI, SECTION A, #6</ReturnReference>
        <Explanation>THE ORGANIZATION HAS ONE CLASS OF VOTING MEMBERS. THE BOARD OF DIRECTORS, IN ITS DISCRETION MAY, FROM TIME TO TIME, DETERMINE THE QUALIFICATION OF THE MEMBERS IN ACCORDANCE WITH THE CODE OF REGULATIONS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>MEMBERS WHO MAY ELECT MEMEBERS</Identifier>
        <ReturnReference>PAGE 6, PART VI, SECTION A, #7A</ReturnReference>
        <Explanation>THE ORGANIZATION HAS ONE CLASS OF VOTING MEMBERS. THEY HAVE THE RIGHT TO VOTE TO ELECT THE GOVERNING BODY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>GOVERNING BODY DECISION APPROVAL</Identifier>
        <ReturnReference>PAGE 6, PART VI, SECTION A, #7B</ReturnReference>
        <Explanation>THE VOTING MEMBERS HAVE APPROVAL RIGHTS OVER ANY AMENDMENT MADE TO THE ORGANIZATION'S GOVERNING DOCUMENTS AND CHANGING OF THE INDEPENDENT AUDITOR.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990 REVIEW PROCESS</Identifier>
        <ReturnReference>PAGE 6, PART VI, SECTION B, #11B</ReturnReference>
        <Explanation>A COMMITTEE OF THE BOARD HAS BEEN ESTABLISHED TO REVIEW THE FINANCIAL RECORDS AND FORM 990. The results of these reviews are then reported to the full board.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>MONITOR AND ENFORCE CONFLICT OF INTEREST POLICY</Identifier>
        <ReturnReference>PAGE 6, PART VI, SECTION B, #12C</ReturnReference>
        <Explanation>DIRECTORS ARE REQUIRED TO SIGN OFF ON THE CONFLICT OF INTEREST POLICY ANNUALLY. THE LEGAL COMMITTEE MONITORS COMPLIANCE. THE BOARD DISCUSSES THE MATTER WHEN A CONFLICT ARISES. THE INDIVIDUAL WITH THE CONFLICT IS NOT PERMITTED TO PARTICIPATE IN THE DISCUSSION OR APPROVAL OF THE TRANSACTION. THE DECISION OF ENGAGING IN THE TRANSACTION IS MADE BY BOARD MEMBERS WHO ARE INDEPENDENT OF THE INDIVIDUAL WITH THE CONFLICT.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROCESS FOR DETERMINING COMPENSATION</Identifier>
        <ReturnReference>PAGE 6, PART VI, SECTION B, #15A &amp; 15B</ReturnReference>
        <Explanation>THE EXECUTIVE COMMITTEE OF THE ALTENHEIM BOARD OF DIRECTORS CONDUCTS AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE AND COMPENSATION AND makes A REPORT, INCLUDING A COMPENSATION RECOMMENDATION, TO THE FULL BOARD. THE FULL BOARD THEN VOTES TO APPROVE THE COMMITTEE'S RECOMMENDATION. A PART OF THE EXECUTIVE COMMITTEE'S PROCESS IS THE REVIEW OF INDUSTRY SALARY AND BENEFITS BENCHMARKING REPORTS FOR THE CEO POSITION. THE CEO CONDUCTS AN ANNUAL PERFORMANCE AND COMPENSATION REVIEW OF THE ALTENHEIM CFO AND OTHER ALTENHEIM EMPLOYEES AND SETS THEIR COMPENSATION WITH THE ADVICE AND COUNSEL OF THE BOARD'S EXECUTIVE COMMITTEE. ALL COMPENSATION DECISIONS ARE DOCUMENTED CONTEMPORANEOUSLY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FAMILY OR BUSINESS RELATIONSHIP</Identifier>
        <ReturnReference>PAGE 6, PART VI, SECTION A, #2</ReturnReference>
        <Explanation>JOHN KEDZIOR AND DAVE KNOWLES HAVE A BUSINESS RELATIONSHIP.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DOCUMENTS AVAILABLE TO PUBLIC</Identifier>
        <ReturnReference>PAGE 6, PART VI, SECTION C, #19</ReturnReference>
        <Explanation>THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST AFTER THE APPROVAL OF THE GOVERNING MEMBERS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>RECONCILIATION OF NET ASSETS</Identifier>
        <ReturnReference>PAGE 12, PART XI, #5</ReturnReference>
        <Explanation>Unrealized loss on investments - $(147,474)</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:ROBERT IVANCIC TITLE:FIRST VICE PRESIDENT HOURS:</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:JOHN KEDZIOR TITLE:TREASURER HOURS:</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:WOLFGANG KEICH TITLE:SECRETARY HOURS:</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:MONICA NEWELL TITLE:PRESIDENT HOURS:</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:INGRID REESE TITLE:DIRECTOR HOURS:</Explanation>
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      <GeneralExplanation>
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      <ExchangeOfAssets>false</ExchangeOfAssets>
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      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
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      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
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