﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2023v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-11-15T09:54:42+00:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>363990892</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Capin Crouse LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>345 Massachusetts Avenue Suite 300</AddressLine1Txt>
        <CityNm>Indianapolis</CityNm>
        <StateAbbreviationCd>IN</StateAbbreviationCd>
        <ZIPCd>46204</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>383533998</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Covenant Community Care Inc</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>COVE</BusinessNameControlTxt>
      <PhoneNum>3135540485</PhoneNum>
      <USAddress>
        <AddressLine1Txt>559 W Grand Blvd</AddressLine1Txt>
        <CityNm>Detroit</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48216</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Joslyn Pettway</PersonNm>
      <PersonTitleTxt>Chief Executive Officer</PersonTitleTxt>
      <SignatureDt>2024-11-15</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Sara Tibbott</PreparerPersonNm>
      <PTIN>P01486965</PTIN>
      <PhoneNum>5055022746</PhoneNum>
      <PreparationDt>2024-11-15</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2024-10-15 13:58:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="IRS990" softwareId="23017437" softwareVersionNum="2023v5.1">
      <PrincipalOfcrBusinessName>
        <BusinessNameLine1Txt>Joslyn Pettway</BusinessNameLine1Txt>
      </PrincipalOfcrBusinessName>
      <USAddress>
        <AddressLine1Txt>559 W Grand Blvd</AddressLine1Txt>
        <CityNm>Detroit</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48216</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>16426218</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.covenantcommunitycare.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2000</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>The mission of Covenant Community Care is to show and share the love of God, as seen in the good news of Jesus Christ, by providing integrated, affordable, and quality health care to those who need it most.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>11</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>182</TotalEmployeeCnt>
      <TotalVolunteersCnt>50</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>7409397</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>7285443</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>9271471</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>9090465</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>11508</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>46390</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>3948</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>3920</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>16696324</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>16426218</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>93982</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>39666</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>10716628</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>10624056</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>149286</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>3863534</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>4001593</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>14674144</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>14665315</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>2022180</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>1760903</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>13399475</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>18272316</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>2407738</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>5519676</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>10991737</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>12752640</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>The mission of Covenant Community Care is to show and share the love of God, as seen in the good news of Jesus Christ, by providing integrated, affordable, and quality health care to those who need it most.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>6631487</ExpenseAmt>
      <RevenueAmt>5522555</RevenueAmt>
      <Desc>In 2023, Covenant Community Care (Covenant) served 17,348 patients through 54,230 visits across our four sites. Covenant's mission states care and concern for "those who need it most" in our communities. This includes the poor, uninsured and underinsured, and others who have been marginalized in society. It also includes our neighbors and people in our region who are seeking compassionate healthcare providers. Our patient population can present challenges that make medical compliance and follow-up, attainment of health goals, and accessing services difficult. Social determinants of health play a major role in the lives of our patients including job situations, home environments, food access, and other factors. We continue to (1) look for ways to sustain and build new partnerships with mental health agencies and other social service organizations, and (2) sustain and develop programs to help us improve how we carry out our mission. In 2023, Covenant started construction on a 10,000 square foot medical, dental, and behavioral health center. This new health center replaced the existing Joy Road and Westland clinics in November 2023.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>3471422</ExpenseAmt>
        <GrantAmt>19591</GrantAmt>
        <RevenueAmt>3004240</RevenueAmt>
        <Desc>Covenant offers oral health services at three clinical sites and through a mobile, school-based dental team. Covenant Michigan, Moross and Joy offer a full array of oral health services with state-of-the-art equipment including dental exams, x-rays, cleanings, fillings, sealants, root canals, extractions, crowns, fluoride treatments, scaling and root planning, and dentures &amp; partial dentures. The school-based team currently cares for students at many Headstart locations, Detroit Public Schools Community District (DPSCD) schools, and non-DPSCD schools. The Team also takes dental services to community-based organizations when they are not working in schools, including the Pope Francis Center, an agency focused on providing meals, supportive services, crisis response, and housing assistance to Detroit community members in need, especially those experiencing homelessness.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>575902</ExpenseAmt>
        <RevenueAmt>563670</RevenueAmt>
        <Desc>Covenant's behavioral health counselors provide care to patients, including substance use services. In addition to outpatient counseling, our primary medical and behavioral health care services are provided through an integrated delivery model. The integration of behavioral health screenings into every patient encounter at Covenant improves service delivery and outcomes in several ways. We identify behavioral health needs earlier in their progression, allowing for early intervention by our Behavioral Health Counselor, by proactively screening our patients. We also believe that by making behavioral health screening a routine practice, it helps to remove the stigma often associated with receiving behavioral health services.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>109639</ExpenseAmt>
        <GrantAmt>20075</GrantAmt>
        <Desc>Covenant has integrated enabling services into our organization to address health care access and utilization barriers. We provide transportation to and from our clinical locations via Lyft (scheduled by our front desk staff). Covenant has a contract with an interpreting service for the provision of foreign language translation and interpretation for our non-English speaking patients. We also have bilingual staff members at our Michigan Avenue facility located in Southwest Detroit, the area with Detroit's largest Hispanic and Latino populations where one in five households have limited English proficiency. Clinic materials (registration forms, sliding fee discount schedules, informational flyers, and signage) are produced in both English and Spanish. We continue to use infographics, when possible, to communicate more effectively with people who have lower levels of literacy.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>109639</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>20075</TotalOtherProgSrvcGrantAmt>
      <TotalProgramServiceExpensesAmt>10788450</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <DonorAdvisedFundInd>false</DonorAdvisedFundInd>
      <ConservationEasementsInd>false</ConservationEasementsInd>
      <CollectionsOfArtInd>false</CollectionsOfArtInd>
      <CreditCounselingInd>false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd>false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd>false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd>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 referenceDocumentId="IRS990ScheduleI">true</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</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 referenceDocumentId="IRS990ScheduleM">true</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>true</ScheduleORequiredInd>
      <IRPDocumentCnt>17</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>182</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <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>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>11</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</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>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MI</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Anna Chavez</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>3135540485</PhoneNum>
        <USAddress>
          <AddressLine1Txt>559 W Grand Blvd</AddressLine1Txt>
          <CityNm>Detroit</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48216</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Catherine Wenz</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Julia Smith</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chairman</TitleTxt>
        <AverageHoursPerWeekRt>4.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Mark Lubienski</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>4.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Mitzi Cardona</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Vice Chairman</TitleTxt>
        <AverageHoursPerWeekRt>4.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Elizabeth Pitts</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Ester Gallegos</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Graciela Villalobos</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Nancyann Turner</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Prince Williams</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Samuel Spruill</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Semmeal Thomas</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Anna Chavez</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <AverageHoursPerWeekRt>36.0</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>118834</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19691</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Joslyn Pettway</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chief Executive Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>198293</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15805</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr Jeffrey Ghioto</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Medical Director</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>178788</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18537</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr Kai Palm</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Medical Director</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>180210</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18144</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr Lynn Quinn</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chief Dental Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>183167</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>2739</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr R C Thebault</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Physician in Charge</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>163559</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17902</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr Scott Stryd</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chief Medical Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>197467</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22365</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1220318</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>115183</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>19</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Rockford Construction Co</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>601 First Street NW</AddressLine1Txt>
            <CityNm>Grand Rapids</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49504</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contractor Services</ServicesDesc>
        <CompensationAmt>6160183</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Henry Schein</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>Dept CH 10560</AddressLine1Txt>
            <CityNm>Palatine</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60055</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Medical, Dental &amp; PVP Supplies</ServicesDesc>
        <CompensationAmt>1116689</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Skynet InnovationsBPI Information Systems</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 715762</AddressLine1Txt>
            <CityNm>Cincinnati</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45271</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT Support</ServicesDesc>
        <CompensationAmt>361935</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Athena Health</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>311 Arsenal St</AddressLine1Txt>
            <CityNm>Watertown</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02472</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EMR Services</ServicesDesc>
        <CompensationAmt>276608</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Entech Medical Staffing</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 776419</AddressLine1Txt>
            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606776419</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Temporary Staffing Services</ServicesDesc>
        <CompensationAmt>103190</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>7067868</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>217575</AllOtherContributionsAmt>
      <NoncashContributionsAmt>64511</NoncashContributionsAmt>
      <TotalContributionsAmt>7285443</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>9090465</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9090465</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>9090465</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>46390</TotalRevenueColumnAmt>
        <ExclusionAmt>46390</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>3549</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>3549</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>3549</TotalRevenueColumnAmt>
        <ExclusionAmt>3549</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>371</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>371</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>371</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>16426218</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9090465</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>50310</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>39666</TotalAmt>
        <ProgramServicesAmt>39666</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>352623</TotalAmt>
        <ManagementAndGeneralAmt>352623</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>8696593</TotalAmt>
        <ProgramServicesAmt>6558598</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2048395</ManagementAndGeneralAmt>
        <FundraisingAmt>89600</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>913502</TotalAmt>
        <ProgramServicesAmt>663669</ProgramServicesAmt>
        <ManagementAndGeneralAmt>235588</ManagementAndGeneralAmt>
        <FundraisingAmt>14245</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>661338</TotalAmt>
        <ProgramServicesAmt>462498</ProgramServicesAmt>
        <ManagementAndGeneralAmt>188913</ManagementAndGeneralAmt>
        <FundraisingAmt>9927</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>14133</TotalAmt>
        <ProgramServicesAmt>4448</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9685</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>70187</TotalAmt>
        <ManagementAndGeneralAmt>70187</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>85383</TotalAmt>
        <ProgramServicesAmt>15763</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44789</ManagementAndGeneralAmt>
        <FundraisingAmt>24831</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>312249</TotalAmt>
        <ProgramServicesAmt>171201</ProgramServicesAmt>
        <ManagementAndGeneralAmt>137951</ManagementAndGeneralAmt>
        <FundraisingAmt>3097</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>742561</TotalAmt>
        <ProgramServicesAmt>407135</ProgramServicesAmt>
        <ManagementAndGeneralAmt>328061</ManagementAndGeneralAmt>
        <FundraisingAmt>7365</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>963600</TotalAmt>
        <ProgramServicesAmt>795245</ProgramServicesAmt>
        <ManagementAndGeneralAmt>168355</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>317847</TotalAmt>
        <ProgramServicesAmt>277535</ProgramServicesAmt>
        <ManagementAndGeneralAmt>40312</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>103530</TotalAmt>
        <ProgramServicesAmt>12782</ProgramServicesAmt>
        <ManagementAndGeneralAmt>90748</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Patient Treatment</Desc>
        <TotalAmt>1379910</TotalAmt>
        <ProgramServicesAmt>1379910</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Other Events</Desc>
        <TotalAmt>12193</TotalAmt>
        <ManagementAndGeneralAmt>11972</ManagementAndGeneralAmt>
        <FundraisingAmt>221</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>14665315</TotalAmt>
        <ProgramServicesAmt>10788450</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3727579</ManagementAndGeneralAmt>
        <FundraisingAmt>149286</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>323350</BOYAmt>
        <EOYAmt>216673</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>7470821</BOYAmt>
        <EOYAmt>6007377</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>1332627</BOYAmt>
        <EOYAmt>2368440</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>329757</BOYAmt>
        <EOYAmt>192872</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>574082</BOYAmt>
        <EOYAmt>24804</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>13703043</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4909527</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>2326214</BOYAmt>
        <EOYAmt>8793516</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1042624</BOYAmt>
        <EOYAmt>668634</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>13399475</BOYAmt>
        <EOYAmt>18272316</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1272345</BOYAmt>
        <EOYAmt>1827922</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <LoansFromOfficersDirectorsGrp>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <EOYAmt>2971125</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>1135393</BOYAmt>
        <EOYAmt>720629</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>2407738</BOYAmt>
        <EOYAmt>5519676</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>9481990</BOYAmt>
        <EOYAmt>12738740</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>1509747</BOYAmt>
        <EOYAmt>13900</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>10991737</BOYAmt>
        <EOYAmt>12752640</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>13399475</BOYAmt>
        <EOYAmt>18272316</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>1760903</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="23017437" softwareVersionNum="2023v5.1">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>5717532</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8256606</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8259666</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7409397</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7285443</CurrentTaxYearAmt>
        <TotalAmt>36928644</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>7938844</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7289395</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8679038</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9271471</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>9090465</CurrentTaxYearAmt>
        <TotalAmt>42269213</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <TotalAmt>0</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <GovtFurnSrvcFcltsVl509Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>13656376</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>15546001</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16938704</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16680868</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>16375908</CurrentTaxYearAmt>
        <TotalAmt>79197857</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>5504</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>869</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1735</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>260</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1846</CurrentTaxYearAmt>
        <TotalAmt>10214</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>5504</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>869</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1735</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>260</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1846</CurrentTaxYearAmt>
        <TotalAmt>10214</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>79187643</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>34031</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>19285</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>20725</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16857</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>49939</CurrentTaxYearAmt>
        <TotalAmt>140837</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <TotalAmt>0</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>34031</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>19285</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>20725</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16857</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>49939</CurrentTaxYearAmt>
        <TotalAmt>140837</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <TotalAmt>0</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>371</CurrentTaxYearAmt>
        <TotalAmt>371</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>13690407</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>15565286</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16959429</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16697725</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>16426218</CurrentTaxYearAmt>
        <TotalAmt>79339065</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.9981</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.9982</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.0016</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part III</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization is a public charity under section 509(a)(2) and completes Schedule A (Form 990), Part III. The organization has analyzed Schedule A (Form 990), Part II and established that it meets the 33 1/3% public support requirements under sections 509(a)(1) and 170(b)(1)(A)(vi), thus it qualifies to use the first listed special rule for Schedule B (Form 990) reporting.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part III, Line 12 Other Income</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION - MISC INCOME, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 371.0, COLUMN F - 371.0;</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="23017437" softwareVersionNum="2023v5.1">
      <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="IRS990ScheduleD" softwareId="23017437" softwareVersionNum="2023v5.1">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>276000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>276000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>10360519</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2705944</DepreciationAmt>
        <BookValueAmt>7654575</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1408556</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1248329</DepreciationAmt>
        <BookValueAmt>160227</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1399291</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>763492</DepreciationAmt>
        <BookValueAmt>635799</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>258677</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>191762</DepreciationAmt>
        <BookValueAmt>66915</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>8793516</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Operating Lease Liability</Desc>
        <Amt>720629</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>720629</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>16426218</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>16426218</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>16426218</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>14665315</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>14665315</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>14665315</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="IRS990ScheduleI" softwareId="23017437" softwareVersionNum="2023v5.1">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Transportation</GrantTypeTxt>
        <RecipientCnt>648</RecipientCnt>
        <NonCashAssistanceAmt>12424</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Cost</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Transportation Services</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Interpretation Services</GrantTypeTxt>
        <RecipientCnt>297</RecipientCnt>
        <NonCashAssistanceAmt>7651</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Cost</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Interpretation Services</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Patient Supplies</GrantTypeTxt>
        <RecipientCnt>8645</RecipientCnt>
        <NonCashAssistanceAmt>19591</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Cost</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Oral Health Care Supplies</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.</FormAndLineReferenceDesc>
        <ExplanationTxt>Covenant provides on-demand transportation assistance to Covenant patients while remaining financially responsible. Covenant has a policy in place to ensure that patients utilize Lyft or other modes of transport with the covered zip codes and within the limitation of the service. Covenant also provides interpreting services by patient request. The supplies are items essential to basic dental care and are distributed based on individual need, which is assessed through conversations with the client.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="23017437" softwareVersionNum="2023v5.1">
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Joslyn Pettway</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chief Executive Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>177565</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>20600</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>128</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15805</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>214098</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr Scott Stryd</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chief Medical Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>188081</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>9386</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22365</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>219832</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr Kai Palm</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Medical Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>172929</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>7038</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>243</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18144</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>198354</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr Jeffrey Ghioto</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Medical Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>172727</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5616</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>445</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18537</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>197325</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr Lynn Quinn</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chief Dental Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>177432</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5735</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2739</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>185906</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dr R C Thebault</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Physician in Charge</TitleTxt>
        <BaseCompensationFilingOrgAmt>151499</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>12060</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>17902</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>181461</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 7 Non-fixed payments</FormAndLineReferenceDesc>
        <ExplanationTxt>The board approved nonfixed payments in the form of discretionary bonuses.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="IRS990ScheduleM" softwareId="23017437" softwareVersionNum="2023v5.1">
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>15</ContributionCnt>
        <NoncashContributionsRptF990Amt>64511</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Cost</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule M, Part I</FormAndLineReferenceDesc>
        <ExplanationTxt>The number of contributions represent the number of contributions received, not the number of items donated.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="23017437" softwareVersionNum="2023v5.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d Description of other program services</FormAndLineReferenceDesc>
        <ExplanationTxt>(Expenses $ 109,639 including grants of $ 20,075) Covenant has integrated enabling services into our organization to address health care access and utilization barriers. We provide transportation to and from our clinical locations via Lyft (scheduled by our front desk staff). Covenant has a contract with an interpreting service for the provision of foreign language translation and interpretation for our non-English speaking patients. We also have bilingual staff members at our Michigan Avenue facility located in Southwest Detroit, the area with Detroit's largest Hispanic and Latino populations where one in five households have limited English proficiency. Clinic materials (registration forms, sliding fee discount schedules, informational flyers, and signage) are produced in both English and Spanish. We continue to use infographics, when possible, to communicate more effectively with people who have lower levels of literacy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1a Delegate broad authority to a committee</FormAndLineReferenceDesc>
        <ExplanationTxt>The Executive Committee is composed of the Chairman of the Board, Vice-Chairman, Secretary, Treasurer and up to two other members of the Board who shall be appointed by the Board of Directors from time to time. The committee is authorized to review and give preliminary consideration for the purpose of making recommendations to the Board. In addition, the Executive Committee is empowered to take any action the Board of Directors authorizes or directs it to take on behalf of the Corporation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is prepared by an independent CPA firms and reviewed in detail by the Chief Financial Officer. The reviewed Form 990 is then provided to the board of directors prior to filing with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization requires all officers and board member to sign annual conflict of interest statement. The Compliance Officer is responsible for reviewing the signed statements and ensuring that interested persons are in compliance with the conflict of interest policy. If an issue were to arise during the course of the board meeting, the board member with a conflict would excuse himself or herself from the decision making process and the board would vote on whether or not the transaction is in the best interest of the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors determines compensation for the Chief Executive Officer. The Executive Committee of the Board prepares a recommendation that considers an evaluation of the CEO's performance, as well as compensation survey data from community health organization or related industries. The Board's decision is documented by memo retained with the organization's payroll and HR files.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b Process to establish compensation of other employees</FormAndLineReferenceDesc>
        <ExplanationTxt>The Chief Executive Officer determines compensation rates for all other officers. The MPCA salary survey is used for comparability data. The approved compensation is documented by memo and retained with the organization's payroll and HR files.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents, conflict of interest policy and financial statements are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 11d Other Miscellaneous Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>Consulting Income - Total Revenue: 371, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 371;</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>