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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>6036</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>57234</TotalAmt>
        <ManagementAndGeneralAmt>57234</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2318116</TotalAmt>
        <ProgramServicesAmt>2184369</ProgramServicesAmt>
        <ManagementAndGeneralAmt>133747</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>15557</TotalAmt>
        <ManagementAndGeneralAmt>15557</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>187408</TotalAmt>
        <ProgramServicesAmt>168938</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18470</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>206830</TotalAmt>
        <ProgramServicesAmt>174858</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31972</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>2295</TotalAmt>
        <ProgramServicesAmt>2295</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>8598</TotalAmt>
        <ProgramServicesAmt>8598</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>135</TotalAmt>
        <ProgramServicesAmt>135</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>236687</TotalAmt>
        <ProgramServicesAmt>213018</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23669</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>92735</TotalAmt>
        <ManagementAndGeneralAmt>92735</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Food</Desc>
        <TotalAmt>409380</TotalAmt>
        <ProgramServicesAmt>409380</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>257999</TotalAmt>
        <ProgramServicesAmt>257999</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Bad Debt</Desc>
        <TotalAmt>104585</TotalAmt>
        <ProgramServicesAmt>104585</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Repairs &amp; Maintenance</Desc>
        <TotalAmt>79893</TotalAmt>
        <ProgramServicesAmt>79893</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>125179</TotalAmt>
        <ProgramServicesAmt>104154</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21025</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>11662174</TotalAmt>
        <ProgramServicesAmt>10732927</ProgramServicesAmt>
        <ManagementAndGeneralAmt>929247</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <SavingsAndTempCashInvstGrp>
        <BOYAmt>919255</BOYAmt>
        <EOYAmt>660139</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>972455</BOYAmt>
        <EOYAmt>847479</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>30141</BOYAmt>
        <EOYAmt>42790</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>26489</BOYAmt>
        <EOYAmt>52158</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>11136371</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>8543109</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1885316</BOYAmt>
        <EOYAmt>2593262</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>4539697</BOYAmt>
        <EOYAmt>4201633</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>1687710</BOYAmt>
        <EOYAmt>1735588</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <TotalAssetsGrp>
        <BOYAmt>10061063</BOYAmt>
        <EOYAmt>10133049</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>948041</BOYAmt>
        <EOYAmt>1204576</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>13422</BOYAmt>
        <EOYAmt>16508</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>7539</BOYAmt>
        <EOYAmt>7539</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>969002</BOYAmt>
        <EOYAmt>1228623</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>8971769</BOYAmt>
        <EOYAmt>8904426</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>120292</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>9092061</BOYAmt>
        <EOYAmt>8904426</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>10061063</BOYAmt>
        <EOYAmt>10133049</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-202426</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>14791</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <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>
        <CurrentTaxYearMinus4YearsAmt>71622</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>612970</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1776998</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>807154</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>202000</CurrentTaxYearAmt>
        <TotalAmt>3470744</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>9468276</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9631469</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9677061</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10695788</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11101699</CurrentTaxYearAmt>
        <TotalAmt>50574293</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>9539898</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>10244439</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>11454059</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11502942</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11303699</CurrentTaxYearAmt>
        <TotalAmt>54045037</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <CurrentTaxYearMinus4YearsAmt>548448</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>301688</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>639138</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>726516</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1134596</CurrentTaxYearAmt>
        <TotalAmt>3350386</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>548448</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>301688</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>639138</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>726516</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1134596</CurrentTaxYearAmt>
        <TotalAmt>3350386</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>50694651</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>100937</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>102829</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>85508</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>74155</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>151049</CurrentTaxYearAmt>
        <TotalAmt>514478</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>100937</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>102829</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>85508</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>74155</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>151049</CurrentTaxYearAmt>
        <TotalAmt>514478</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>9640835</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>10347268</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>11539567</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11577097</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11454748</CurrentTaxYearAmt>
        <TotalAmt>54559515</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.92920</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.93690</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00940</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00850</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>778646</OtherCostOrOtherBasisAmt>
        <BookValueAmt>778646</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>6865607</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>5823477</DepreciationAmt>
        <BookValueAmt>1042130</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3266569</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2528453</DepreciationAmt>
        <BookValueAmt>738116</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>225549</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>191179</DepreciationAmt>
        <BookValueAmt>34370</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>2593262</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>Mission Investment Fund</Desc>
        <BookValueAmt>1735588</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>1735588</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated Third Party Payor Settlement</Desc>
        <Amt>7539</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>7539</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>11474539</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>14791</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>14791</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>11459748</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>11459748</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>11662174</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>11662174</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>11662174</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IV, Line 2b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Home acts as custodian for the funds of the residents. These funds are included in cash and accounts payable in the financial statements. Resident trust funds totaled $16,508 and $13,422 at December 31, 2023 and 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Home believes that it has appropriate support for any tax position taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Home would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The membership of this corporation shall consist of Christian Congregations within the Corporation's service area electing to participate. At least 51% of the Corporate Congregations shall be affiliated with the Evangelical Lutheran Church in America or its successor.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Each member congregation shall be entitled to be represented by no less than two delegates at any membership meeting. Member congregations having more than 200 confirmed members may have one additional delegate for each 100 confirmed members or major fraction thereof over the first 200 confirmed members. In addition to the chosen delegates, all pastors serving member congregations shall be delegates.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 8b</FormAndLineReferenceDesc>
        <ExplanationTxt>While the bylaws allow for an Executive Committee, the committee has not met in the current year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is distributed at a board meeting and reviewed by the board prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Annually, board members and officers of the organization are required to review the conflict of interest policy. New board members are required to review and disclose any conflicts upon election. The Board of Directors and the Administrator review and determine if a conflict occurs. If one does occur, that individual must abstain from voting on that issue.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The officers and directors of the organization determine the salary of the Administrator. The officers and directors have information available for compensation of other administrators at comparable facilities in North Dakota with similar job responsibilities. An employment contract with the Administrator is negotiated on an annual basis. There are no other officers or key employees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents, conflict of interest policy and the financial statements are not available for public inspection.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Contract Services: Program service expenses 2,149,912. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,149,912. Data Processing: Program service expenses 0. Management and general expenses 133,747. Fundraising expenses 0. Total expenses 133,747. Therapies: Program service expenses 32,417. Management and general expenses 0. Fundraising expenses 0. Total expenses 32,417. Bank Charges: Program service expenses 2,040. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,040.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
