﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-11-15T14:02:21-06:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>450250958</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Eide Bailly LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>4585 Coleman St Ste 200</AddressLine1Txt>
        <CityNm>Bismarck</CityNm>
        <StateAbbreviationCd>ND</StateAbbreviationCd>
        <ZIPCd>58503</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>450343518</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Souris Valley Care Center Inc</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>SOUR</BusinessNameControlTxt>
      <PhoneNum>7013382072</PhoneNum>
      <USAddress>
        <AddressLine1Txt>300 Main Street South</AddressLine1Txt>
        <CityNm>Velva</CityNm>
        <StateAbbreviationCd>ND</StateAbbreviationCd>
        <ZIPCd>58790</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Valerie Heisler</PersonNm>
      <PersonTitleTxt>Board Chairperson</PersonTitleTxt>
      <PhoneNum>7013382072</PhoneNum>
      <SignatureDt>2024-11-15</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Lisa Chaffee CPA</PreparerPersonNm>
      <PTIN>P00193453</PTIN>
      <PhoneNum>7012551091</PhoneNum>
      <PreparationDt>2024-11-15</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2024-10-15 13:58:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="4">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>Valerie Heisler</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>300 Main Street South</AddressLine1Txt>
        <CityNm>Velva</CityNm>
        <StateAbbreviationCd>ND</StateAbbreviationCd>
        <ZIPCd>58790</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>6125924</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>N/A</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1977</FormationYr>
      <LegalDomicileStateCd>ND</LegalDomicileStateCd>
      <ActivityOrMissionDesc>50 Bed Skilled Nursing Care Facility and 16 unit Assisted Living Facility</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>8</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>8</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>125</TotalEmployeeCnt>
      <TotalVolunteersCnt>27</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>70863</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>11462</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>5393294</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>6108685</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1741</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>5777</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>196463</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>5662361</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>6125924</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>2859360</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>3552983</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>2919879</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>2437816</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>5779239</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>5990799</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-116878</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>135125</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>2449289</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>2629663</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>442371</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>461384</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>2006918</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>2168279</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>To share God's love in word and in deed by providing shelter to older persons and others in need, believing that "In Christ's Love, Everyone is Someone".</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>4628404</ExpenseAmt>
      <RevenueAmt>6108685</RevenueAmt>
      <Desc>Souris Valley Care Center (the Center) is a non-profit senior living center in Velva, North Dakota. The Center operates a 50 skilled care bed long-term care facility and a 16 unit assisted living center.</Desc>
      <TotalProgramServiceExpensesAmt>4628404</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">1</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>0</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>15</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>125</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>8</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>8</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>1</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>0</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Doug Panchot</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>7013382072</PhoneNum>
        <USAddress>
          <AddressLine1Txt>300 Main Street South</AddressLine1Txt>
          <CityNm>Velva</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58790</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>Larry Lee</PersonNm>
        <TitleTxt>Board Chairperson</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Valerie Heisler</PersonNm>
        <TitleTxt>Board Vice Chairperson</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Bonnie Thom</PersonNm>
        <TitleTxt>Board Secretary</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Shawn Vedaa</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tracy Krueger</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kerry Clark</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dan Flaherty</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>David Kramer</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Doug Panchot</PersonNm>
        <TitleTxt>Administrator</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Krista Talley</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <AverageHoursPerWeekRt>47.88</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>125621</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Connie Heit</PersonNm>
        <TitleTxt>LPN</TitleTxt>
        <AverageHoursPerWeekRt>54.29</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>117983</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24471</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>243604</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>24471</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>2</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SanfordGood Samaritan</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4800 W 57th St</AddressLine1Txt>
            <CityNm>Sioux Falls</CityNm>
            <StateAbbreviationCd>SD</StateAbbreviationCd>
            <ZIPCd>57108</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Management Services</ServicesDesc>
        <CompensationAmt>346632</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>11462</AllOtherContributionsAmt>
      <TotalContributionsAmt>11462</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Resident Service Reven</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>6030317</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6030317</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>78368</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>78368</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>6108685</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>5777</TotalRevenueColumnAmt>
        <ExclusionAmt>5777</ExclusionAmt>
      </InvestmentIncomeGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>6125924</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6108685</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>5777</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>2961115</TotalAmt>
        <ProgramServicesAmt>2339661</ProgramServicesAmt>
        <ManagementAndGeneralAmt>621454</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>31769</TotalAmt>
        <ProgramServicesAmt>20871</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10898</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>342394</TotalAmt>
        <ProgramServicesAmt>257995</ProgramServicesAmt>
        <ManagementAndGeneralAmt>84399</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>217705</TotalAmt>
        <ProgramServicesAmt>172544</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45161</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>346632</TotalAmt>
        <ManagementAndGeneralAmt>346632</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1073082</TotalAmt>
        <ProgramServicesAmt>1015795</ProgramServicesAmt>
        <ManagementAndGeneralAmt>57287</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>4494</TotalAmt>
        <ProgramServicesAmt>204</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4290</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>71881</TotalAmt>
        <ProgramServicesAmt>48470</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23411</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>208491</TotalAmt>
        <ProgramServicesAmt>166256</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42235</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>42540</TotalAmt>
        <ProgramServicesAmt>38367</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4173</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>6420</TotalAmt>
        <ProgramServicesAmt>5082</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1338</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>732</TotalAmt>
        <ManagementAndGeneralAmt>732</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>136596</TotalAmt>
        <ProgramServicesAmt>115248</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21348</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>56956</TotalAmt>
        <ManagementAndGeneralAmt>56956</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Food</Desc>
        <TotalAmt>226282</TotalAmt>
        <ProgramServicesAmt>225806</ProgramServicesAmt>
        <ManagementAndGeneralAmt>476</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>171672</TotalAmt>
        <ProgramServicesAmt>158727</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12945</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Repairs and Maintenance</Desc>
        <TotalAmt>82584</TotalAmt>
        <ProgramServicesAmt>82584</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Bad Debt (Recovery)</Desc>
        <TotalAmt>-26649</TotalAmt>
        <ProgramServicesAmt>-26649</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>36103</TotalAmt>
        <ProgramServicesAmt>7443</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28660</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>5990799</TotalAmt>
        <ProgramServicesAmt>4628404</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1362395</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>121643</BOYAmt>
        <EOYAmt>175</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>486360</BOYAmt>
        <EOYAmt>170201</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>437036</BOYAmt>
        <EOYAmt>392012</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>9010</BOYAmt>
        <EOYAmt>7993</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <LandBldgEquipCostOrOtherBssAmt>5431477</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4123811</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1395240</BOYAmt>
        <EOYAmt>1307666</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <EOYAmt>751616</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <TotalAssetsGrp>
        <BOYAmt>2449289</BOYAmt>
        <EOYAmt>2629663</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>344320</BOYAmt>
        <EOYAmt>401921</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>14227</BOYAmt>
        <EOYAmt>6254</EOYAmt>
      </DeferredRevenueGrp>
      <EscrowAccountLiabilityGrp>
        <EOYAmt>53209</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>38115</BOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>45709</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>442371</BOYAmt>
        <EOYAmt>461384</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>1885705</BOYAmt>
        <EOYAmt>2011333</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>121213</BOYAmt>
        <EOYAmt>156946</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2006918</BOYAmt>
        <EOYAmt>2168279</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>2449289</BOYAmt>
        <EOYAmt>2629663</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>135125</ReconcilationRevenueExpnssAmt>
      <PriorPeriodAdjustmentsAmt>26236</PriorPeriodAdjustmentsAmt>
      <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>29979</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>48283</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5680</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>70863</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11462</CurrentTaxYearAmt>
        <TotalAmt>166267</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>4065764</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4004600</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4102838</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5543609</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>6108685</CurrentTaxYearAmt>
        <TotalAmt>23825496</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>4095743</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4052883</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4108518</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5614472</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>6120147</CurrentTaxYearAmt>
        <TotalAmt>23991763</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <CurrentTaxYearMinus4YearsAmt>1158146</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1289217</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1482010</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1938594</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1933254</CurrentTaxYearAmt>
        <TotalAmt>7801221</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>1158146</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1289217</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1482010</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1938594</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1933254</CurrentTaxYearAmt>
        <TotalAmt>7801221</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>16190542</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>5106</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3179</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1683</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1541</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5777</CurrentTaxYearAmt>
        <TotalAmt>17286</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>5106</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3179</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1683</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1541</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5777</CurrentTaxYearAmt>
        <TotalAmt>17286</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>4100849</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4056062</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4110201</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5616013</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>6125924</CurrentTaxYearAmt>
        <TotalAmt>24009049</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.67440</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99930</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00070</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00070</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>39598</OtherCostOrOtherBasisAmt>
        <BookValueAmt>39598</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>4337726</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3337923</DepreciationAmt>
        <BookValueAmt>999803</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>180566</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>170679</DepreciationAmt>
        <BookValueAmt>9887</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>873587</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>615209</DepreciationAmt>
        <BookValueAmt>258378</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>1307666</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>6125924</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>6125924</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>6125924</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>5990799</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>5990799</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>5990799</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IV, Line 2b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Center acts as custodian for the funds of the nursing facility residents. The Center also holds security deposits for tenants of the assisted living. These funds are included in assets held in trust and resident trust funds and security deposits and payable in the financial statements. Resident trust funds totaled $4,070 as of December 31, 2023. Security deposits totaled $49,139 at December 31, 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Center 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 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The Center has entered into a management agreement with Sanford which includes certain administrative support services and the administrator. The Center paid $346,632 for these services in the year ending December 31, 2023. Compensation paid to Doug Panchot for his services as administrator include: Compensation: $119,824 Other Benefits: $28,075</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 8b</FormAndLineReferenceDesc>
        <ExplanationTxt>There are no committees with the authority to act on behalf of the full board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors reviews the 990 prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>All employees and board members are covered by the organizations conflict of interest policy. Potential conflicts are reviewed by the organizations board of Trustees or Executive Compliance Commitee (ECC). If a potential conflict arises with an employee the immediate supervisor or Administrator will develop an appropriate administrative or management plans or elimination of the conflict of interest. If a potential conflict arises with management or a board member the person with the potential conflict shall not be present, vote or take any action when their disclosure is under consideration by the ECC or Board of Trustees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes its governing documents, conflict of interest policy, and financial statements available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Consulting Services: Program service expenses 3,600. Management and general expenses 8,205. Fundraising expenses 0. Total expenses 11,805. Other Professional Fees: Program service expenses 1,012,195. Management and general expenses 49,082. Fundraising expenses 0. Total expenses 1,061,277.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>