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      <TotalOtherRevenue>1882699</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>15120553</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>14876813</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>77455</UnrelatedBusinessRevenue>
        <ExclusionAmount>108296</ExclusionAmount>
      </TotalRevenue>
      <OtherSalariesAndWages>
        <Total>7427143</Total>
        <ProgramServices>6277675</ProgramServices>
        <ManagementAndGeneral>1107825</ManagementAndGeneral>
        <Fundraising>41643</Fundraising>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>212943</Total>
        <ProgramServices>179418</ProgramServices>
        <ManagementAndGeneral>31662</ManagementAndGeneral>
        <Fundraising>1863</Fundraising>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>1629858</Total>
        <ProgramServices>1379327</ProgramServices>
        <ManagementAndGeneral>243411</ManagementAndGeneral>
        <Fundraising>7120</Fundraising>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>556981</Total>
        <ProgramServices>470712</ProgramServices>
        <ManagementAndGeneral>83067</ManagementAndGeneral>
        <Fundraising>3202</Fundraising>
      </PayrollTaxes>
      <FeesForServicesLegal>
        <Total>115545</Total>
        <ManagementAndGeneral>115545</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesOther>
        <Total>135069</Total>
        <ProgramServices>112060</ProgramServices>
        <ManagementAndGeneral>19775</ManagementAndGeneral>
        <Fundraising>3234</Fundraising>
      </FeesForServicesOther>
      <Advertising>
        <Total>104063</Total>
        <ProgramServices>87848</ProgramServices>
        <ManagementAndGeneral>15503</ManagementAndGeneral>
        <Fundraising>712</Fundraising>
      </Advertising>
      <OfficeExpenses>
        <Total>445092</Total>
        <ProgramServices>377063</ProgramServices>
        <ManagementAndGeneral>66540</ManagementAndGeneral>
        <Fundraising>1489</Fundraising>
      </OfficeExpenses>
      <Occupancy>
        <Total>427343</Total>
        <ProgramServices>363242</ProgramServices>
        <ManagementAndGeneral>64101</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>31406</Total>
        <ProgramServices>26149</ProgramServices>
        <ManagementAndGeneral>4615</ManagementAndGeneral>
        <Fundraising>642</Fundraising>
      </Travel>
      <Interest>
        <Total>215215</Total>
        <ProgramServices>182933</ProgramServices>
        <ManagementAndGeneral>32282</ManagementAndGeneral>
      </Interest>
      <DepreciationDepletion>
        <Total>785918</Total>
        <ProgramServices>666386</ProgramServices>
        <ManagementAndGeneral>117598</ManagementAndGeneral>
        <Fundraising>1934</Fundraising>
      </DepreciationDepletion>
      <Insurance>
        <Total>356211</Total>
        <ProgramServices>302779</ProgramServices>
        <ManagementAndGeneral>53432</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>Bad Debt</Description>
        <Total>983105</Total>
        <ProgramServices>835639</ProgramServices>
        <ManagementAndGeneral>147466</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>lifestar</Description>
        <Total>570274</Total>
        <ProgramServices>484733</ProgramServices>
        <ManagementAndGeneral>85541</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>vehicle expense</Description>
        <Total>508668</Total>
        <ProgramServices>432368</ProgramServices>
        <ManagementAndGeneral>76300</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Repairs &amp; Maintenance</Description>
        <Total>154684</Total>
        <ProgramServices>131434</ProgramServices>
        <ManagementAndGeneral>23203</ManagementAndGeneral>
        <Fundraising>47</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>dues &amp; Publications</Description>
        <Total>46237</Total>
        <ProgramServices>38914</ProgramServices>
        <ManagementAndGeneral>6868</ManagementAndGeneral>
        <Fundraising>455</Fundraising>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>81808</Total>
        <ProgramServices>69411</ProgramServices>
        <ManagementAndGeneral>12240</ManagementAndGeneral>
        <Fundraising>157</Fundraising>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>14787563</Total>
        <ProgramServices>12418091</ProgramServices>
        <ManagementAndGeneral>2306974</ManagementAndGeneral>
        <Fundraising>62498</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>172133</BOY>
        <EOY>250058</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>89939</BOY>
      </SavingsAndTempCashInvestments>
      <AccountsReceivable>
        <BOY>1762062</BOY>
        <EOY>1485687</EOY>
      </AccountsReceivable>
      <InventoriesForSaleOrUse>
        <BOY>37782</BOY>
        <EOY>28414</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>145831</BOY>
        <EOY>94338</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>14598003</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>7837544</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>7000335</BOY>
        <EOY>6760459</EOY>
      </LandBuildingsEquipmentBasisNet>
      <OtherAssetsTotal>
        <BOY>238087</BOY>
        <EOY>183828</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>9446169</BOY>
        <EOY>8802784</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>1934517</BOY>
        <EOY>1530133</EOY>
      </AccountsPayableAccruedExpenses>
      <MortNotesPyblSecuredInvestProp>
        <BOY>4160573</BOY>
        <EOY>3643037</EOY>
      </MortNotesPyblSecuredInvestProp>
      <OtherLiabilities>
        <BOY>254803</BOY>
        <EOY>198396</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>6349893</BOY>
        <EOY>5371566</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>3075648</BOY>
        <EOY>3408638</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>20628</BOY>
        <EOY>22580</EOY>
      </TemporarilyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>3096276</BOY>
        <EOY>3431218</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>9446169</BOY>
        <EOY>8802784</EOY>
      </TotalLiabNetAssetsFundBalances>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>0</AccountantCompileOrReview>
      <FSAudited>1</FSAudited>
      <AuditCommittee>1</AuditCommittee>
      <FinancialStatementSeparate>X</FinancialStatementSeparate>
      <FederalGrantAuditRequired>0</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2>X</PubliclySupportedOrg509a2>
      <GiftsGrantsContribReceived509>
        <CurrentTaxYearMinus4Years>943963</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>958815</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>146451</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>43808</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>57989</CurrentTaxYear>
        <Total>2151026</Total>
      </GiftsGrantsContribReceived509>
      <GrossReceiptsFromAdmissions>
        <CurrentTaxYearMinus4Years>11561823</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>13301582</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>13882753</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>13953314</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>13071569</CurrentTaxYear>
        <Total>65771041</Total>
      </GrossReceiptsFromAdmissions>
      <Total509>
        <CurrentTaxYearMinus4Years>12505786</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>14260397</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>14029204</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>13997122</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>13129558</CurrentTaxYear>
        <Total>67922067</Total>
      </Total509>
      <AmtsRecdFromDisqualPersons>
        <Total>0</Total>
      </AmtsRecdFromDisqualPersons>
      <AmtsFromSubstContributors>
        <Total>0</Total>
      </AmtsFromSubstContributors>
      <SupportFromDQPsEtc>
        <Total>0</Total>
      </SupportFromDQPsEtc>
      <PublicSupportTotal509>67922067</PublicSupportTotal509>
      <GrossInvestmentIncome509>
        <CurrentTaxYearMinus4Years>54919</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>54091</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>139521</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>103988</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>194669</CurrentTaxYear>
        <Total>547188</Total>
      </GrossInvestmentIncome509>
      <InvestmentIncomeAndUBTI>
        <CurrentTaxYearMinus4Years>54919</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>54091</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>139521</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>103988</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>194669</CurrentTaxYear>
        <Total>547188</Total>
      </InvestmentIncomeAndUBTI>
      <NetIncomeFromOtherUBI>
        <CurrentTaxYearMinus4Years>5576</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>75240</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>69806</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>79539</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>77455</CurrentTaxYear>
        <Total>307616</Total>
      </NetIncomeFromOtherUBI>
      <OtherIncome509>
        <CurrentTaxYearMinus4Years>2232235</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>1308472</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>1151841</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>1104698</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>1805244</CurrentTaxYear>
        <Total>7602490</Total>
      </OtherIncome509>
      <TotalSupportTotal>
        <CurrentTaxYearMinus4Years>14798516</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>15698200</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>15390372</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>15285347</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>15206926</CurrentTaxYear>
        <Total>76379361</Total>
      </TotalSupportTotal>
      <PublicSupportPercentage509>0.88930</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.90770</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0.00720</InvestmentIncomePercentage>
      <PriorYrInvestIncomePercentage>0.00600</PriorYrInvestIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <Land>
        <OtherCostOrOtherBasis>43000</OtherCostOrOtherBasis>
        <BookValue>43000</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>1404103</OtherCostOrOtherBasis>
        <Depreciation>1006217</Depreciation>
        <BookValue>397886</BookValue>
      </Buildings>
      <LeaseholdImprovements>
        <OtherCostOrOtherBasis>170738</OtherCostOrOtherBasis>
        <Depreciation>58529</Depreciation>
        <BookValue>112209</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <OtherCostOrOtherBasis>12944675</OtherCostOrOtherBasis>
        <Depreciation>6772798</Depreciation>
        <BookValue>6171877</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>35487</OtherCostOrOtherBasis>
        <BookValue>35487</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>6760459</TotalOfBookValueLandBuildings>
      <OtherLiabilities>
        <Description>Unearned Revenue</Description>
        <Amount>198396</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>198396</TotalOfAmounts>
      <TotalRevenue>15120553</TotalRevenue>
      <TotalExpenses>14787563</TotalExpenses>
      <ExcessOrDeficitForYear>332990</ExcessOrDeficitForYear>
      <OtherAmount>1952</OtherAmount>
      <TotalAdjustments>1952</TotalAdjustments>
      <ExcessOrDeficitPerFS>334942</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>14310553</TotRevenueEtcAuditedFinclStmt>
      <RevenueNotRptdF990>0</RevenueNotRptdF990>
      <RevenueSubtotal>14310553</RevenueSubtotal>
      <OtherRevenuesNotIncluded>810000</OtherRevenuesNotIncluded>
      <RevenueNotRptdOnFinStmt>810000</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>15120553</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>14787563</TotExpensesEtcAuditedFinclStmt>
      <ExpensesNotRptdF990>0</ExpensesNotRptdF990>
      <ExpensesSubtotal>14787563</ExpensesSubtotal>
      <ExpensesNotRptdOnFinStmt>0</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>14787563</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIV>
        <Identifier>Part X:</Identifier>
        <ReturnReference>Description of Uncertain Tax Positions Under FIN 48:</ReturnReference>
        <Explanation>EmergyCare is a not-for-profit corporation and is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes has been provided. EmergyCare adopted the standard for accounting for uncertainty in income taxes recognized in a company's financial statements that prescribes a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold has not been met. The standard also provides guidance on derecognition, classification, interest and penalties, accounting for interim periods, and disclosure. Management has determined that the adoption of the standard did not have a material effect on the financial statements. EmergyCare's income tax returns for the years ended 2009, 2008, and 2007, remain subject to examination by the Internal Revenue Service and state agencies.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XI, Line 8 - Other Adjustments:</Identifier>
        <Explanation>contributions, restricted to use: 22580. Net Assets released from restrictions: -15711. Forfeiture of grant funds: -4917.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XII, Line 4b - Other Adjustments:</Identifier>
        <Explanation>Operations Subsidy: 800000. net assets released from restriction: 10000.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommittee>X</CompensationCommittee>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>1</SeverancePayment>
      <SupplementalNonqualRetirePlan>0</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>0</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>0</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>0</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>0</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>0</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>0</AnyNonFixedPayments>
      <InitialContractException>0</InitialContractException>
      <Form990ScheduleJPartII>
        <NameBusiness>
          <BusinessNameLine1>Richard Gibbons</BusinessNameLine1>
        </NameBusiness>
        <BaseCompensationFilingOrg>41540</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>1722</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>3763</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>47025</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Line 4a</ReturnReference>
        <Explanation>Richard Gibbons, Former CEO receive a severance payment of $39,444.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 6</Identifier>
        <Explanation>Hamot Medical Center and Saint Vincent Health Center are members of Emergycare, Inc.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 7a</Identifier>
        <Explanation>The following organizations may elect one or more members of the governing body: 1. Hamot Medical Center 2. Saint Vincent Health Center 3. Titusville Area Hospital 4. Kane Community Hospital 5. Warren General Hospital</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 11</Identifier>
        <Explanation>Emergycare Inc. has A CPA FIRM PREPARE ITS FORM 990. The return is completed in draft form and reviewed by manangement of the organization. The Form 990 is then provided to the board of directors for review before it is filed.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 12c</Identifier>
        <Explanation>Emergycare Inc. ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM. DURING BOARD MEETINGS, IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 15</Identifier>
        <Explanation>Emergycare Inc.'s board of directors annually reviews and approves the compensation of their organization's top management and key employees.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section C, line 18</Identifier>
        <Explanation>Emergycare Inc. MAKES ITS FORM 990 and form 1023 available TO THE PUBLIC upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section C, line 19</Identifier>
        <Explanation>AT THIS TIME, Emergycare Inc. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS available TO THE GENERAL PUBLIC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Explanation>Emergycare's board of directors assumes responsibility for the oversight of the audit and selection of an independent accountant. The process has not changed from prior year.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>