<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2022v5.0" xsi:schemaLocation="http://www.irs.gov/efile">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-02-14T20:01:31-08:00</ReturnTs>
    <TaxPeriodEndDt>2022-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>593460369</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Rhonda L Hinds &amp; Associates CPA PA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>160 McLeod St</AddressLine1Txt>
        <CityNm>Merritt Island</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>32953</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>854058649</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Center for Aging and Rehabilitation of Gulf County Inc</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>CENT</BusinessNameControlTxt>
      <PhoneNum>9543674563</PhoneNum>
      <USAddress>
        <AddressLine1Txt>3550 Powerline Road</AddressLine1Txt>
        <CityNm>Oakland Park</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33309</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Alan Brock</PersonNm>
      <PersonTitleTxt>Chairman</PersonTitleTxt>
      <PhoneNum>9543674563</PhoneNum>
      <SignatureDt>2024-02-14</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>Alan</PersonFirstNm>
        <PersonLastNm>Brock</PersonLastNm>
      </PersonFullName>
      <SSN>XXX-XX-XXXX</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Rhonda Hinds</PreparerPersonNm>
      <PTIN>P00038396</PTIN>
      <PhoneNum>3214542266</PhoneNum>
      <PreparationDt>2024-02-14</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
        <FederatedAssuranceLevelCd>FAL1</FederatedAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="4">
    <IRS990 documentId="IRS990-01" referenceDocumentId="IRS990ScheduleO-01" softwareId="22015534">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>Gulf Shores Care Center</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>Alan Brock</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>3550 Powerline Road</AddressLine1Txt>
        <CityNm>Oakland Park</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33309</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>6998062</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>N/A</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2021</FormationYr>
      <LegalDomicileStateCd>FL</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Skilled nursing facility to provide medical, continuous nursing, health and social services to patients.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>4</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>4</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>4988496</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>6991023</CYProgramServiceRevenueAmt>
      <CYInvestmentIncomeAmt>3983</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>3056</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>4988496</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>6998062</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <CYSalariesCompEmpBnftPaidAmt>0</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>6759616</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>8163113</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>6759616</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>8163113</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-1771120</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1165051</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>2060229</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>1922018</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>3831349</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>4858188</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>-1771120</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>-2936170</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>Skilled nursing facility to provide medical, continuous nursing, health and social services to patients.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>7946768</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>6998062</RevenueAmt>
      <Desc>Skilled nursing facility to provide medical, continuous nursing, health and social services to patients.</Desc>
      <TotalProgramServiceExpensesAmt>7946768</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA-01" referenceDocumentName="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD-01" referenceDocumentName="IRS990ScheduleD">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>false</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>false</ScheduleORequiredInd>
      <IRPDocumentCnt>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>4</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>4</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>false</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>false</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <BooksInCareOfDetail>
        <PersonNm>Robert Kelly</PersonNm>
        <PhoneNum>9543674563</PhoneNum>
        <USAddress>
          <AddressLine1Txt>3550 Powerline Road</AddressLine1Txt>
          <CityNm>Oakland Park</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33309</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>George Fernandez</PersonNm>
        <TitleTxt>Chairman of the Board</TitleTxt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Brett Hoge</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Alex Barrett</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Kelly</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>false</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ProgramServiceRevenueGrp>
        <Desc>Medicaid</Desc>
        <BusinessCd>623110</BusinessCd>
        <TotalRevenueColumnAmt>3182527</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Medicare</Desc>
        <BusinessCd>623110</BusinessCd>
        <TotalRevenueColumnAmt>2929749</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Hospice</Desc>
        <BusinessCd>623110</BusinessCd>
        <TotalRevenueColumnAmt>566678</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Outpatient Therapy</Desc>
        <BusinessCd>623110</BusinessCd>
        <TotalRevenueColumnAmt>179236</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Private</Desc>
        <BusinessCd>623110</BusinessCd>
        <TotalRevenueColumnAmt>121865</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>10968</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>6991023</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>3983</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>Miscellaneous</Desc>
        <BusinessCd>623110</BusinessCd>
        <TotalRevenueColumnAmt>3056</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3056</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>3056</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>6998062</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6998062</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>22883</TotalAmt>
        <ProgramServicesAmt>22883</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>72000</TotalAmt>
        <ProgramServicesAmt>18000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>54000</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>208866</TotalAmt>
        <ProgramServicesAmt>52217</ProgramServicesAmt>
        <ManagementAndGeneralAmt>156649</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>4351164</TotalAmt>
        <ProgramServicesAmt>4351164</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>16537</TotalAmt>
        <ProgramServicesAmt>15568</ProgramServicesAmt>
        <ManagementAndGeneralAmt>969</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>2601393</TotalAmt>
        <ProgramServicesAmt>2601393</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>7427</TotalAmt>
        <ProgramServicesAmt>2700</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4727</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InsuranceGrp>
        <TotalAmt>31471</TotalAmt>
        <ProgramServicesAmt>31471</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Bad Debt</Desc>
        <TotalAmt>60000</TotalAmt>
        <ProgramServicesAmt>60000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Bank Fees</Desc>
        <TotalAmt>2</TotalAmt>
        <ProgramServicesAmt>2</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Quality Assessment Fees</Desc>
        <TotalAmt>437496</TotalAmt>
        <ProgramServicesAmt>437496</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Permits/Dues/Licenses</Desc>
        <TotalAmt>7772</TotalAmt>
        <ProgramServicesAmt>7772</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>346102</TotalAmt>
        <ProgramServicesAmt>346102</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>8163113</TotalAmt>
        <ProgramServicesAmt>7946768</ProgramServicesAmt>
        <ManagementAndGeneralAmt>216345</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>26684</BOYAmt>
        <EOYAmt>1000</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>538321</BOYAmt>
        <EOYAmt>561792</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>1443246</BOYAmt>
        <EOYAmt>1308172</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>32160</BOYAmt>
        <EOYAmt>47074</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>0</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>0</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>5553</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>14265</BOYAmt>
        <EOYAmt>3980</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>2060229</BOYAmt>
        <EOYAmt>1922018</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2681811</BOYAmt>
        <EOYAmt>3708650</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>1149538</BOYAmt>
        <EOYAmt>1149538</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3831349</BOYAmt>
        <EOYAmt>4858188</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowFASB117Ind>X</OrgDoesNotFollowFASB117Ind>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>-1771120</BOYAmt>
        <EOYAmt>-2936170</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>-1771120</BOYAmt>
        <EOYAmt>-2936170</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>2060229</BOYAmt>
        <EOYAmt>1922018</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1165051</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA-01" softwareId="22015534">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <OtherSupportSumAmt>0</OtherSupportSumAmt>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>0</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TaxRevLeviedOrgnztnlBnft170Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft170Grp>
      <GovtFurnSrvcFcltsVl170Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>0</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>0</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>0</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <TotalAmt>0</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <TotalAmt>0</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <TotalAmt>0</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>0</TotalSupportAmt>
      <First5Years170Ind>X</First5Years170Ind>
      <PublicSupportCY170Pct>0</PublicSupportCY170Pct>
      <PublicSupportTotal509Amt>0</PublicSupportTotal509Amt>
      <PublicSupportCY509Pct>0</PublicSupportCY509Pct>
      <InvestmentIncomeCYPct>0</InvestmentIncomeCYPct>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="IRS990ScheduleD-01" softwareId="22015534">
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>0</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Deposits</Desc>
        <BookValueAmt>3980</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>3980</TotalBookValueOtherAssetsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="22015534">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Copy is provided at board meeting to review</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Bio Waste Service 495. 495. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Contracted Labor 2734445. 2734445. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Contracted Services 75630. 75630. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Dietary Services 834559. 834559. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Laboratory 9610. 9610. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Laundry Services 172050. 172050. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Therapy Services 511430. 511430. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Xray Services 9225. 9225. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Ultrasounds Services 3720. 3720. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
