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      <Desc>HEALTH CARE FOR THE HOMELESS: CARE ALLIANCE HEALTH CENTER WAS ESTABLISHED IN 1985 AS ONE OF THE ORIGINAL ROBERT WOOD JOHNSON FOUNDATION HEALTH CARE FOR THE HOMELESS PROJECTS IN THE NATION AND IN 1993 BECAME AN INDEPENDENT NONPROFIT ORGANIZATION. TODAY, CARE ALLIANCE CONTINUES ITS FOCUS ON PROVIDING HEALTH CARE TO THOSE EXPERIENCING HOMELESSNESS IN THE CITY OF CLEVELAND AS A FEDERALLY QUALIFIED HEALTH CENTER RECEIVING FUNDING THROUGH THE U.S. DEPARTMENT OF HEALTHRESOURCES AND SERVICES ADMINISTRATION (HRSA). AFTER MORE THAN THIRTY YEARS OF PROVIDING HEALTH CARE TO THE HOMELESS POPULATION, CARE ALLIANCE HAS BUILT A STRONG RAPPORT WITH THIS POPULATION AS WELL AS DEVELOPING TREMENDOUS RESPECT AS AN INTEGRAL MEMBER OF THE LOCAL DELIVERY SYSTEM OF SAFETY-NET PROVIDERS. THE HEALTH CARE FOR THE HOMELESS PROGRAM OFFERS PRIMARY HEALTH CARE AND SUPPORTIVE SERVICES AT ALL THREE OF CARE ALLIANCE'S PRIMARY CLINIC LOCATIONS AS WELL AS AT OUTREACH SITES THROUGHOUT THE CITY WHERE PEOPLE WHO ARE HOMELESS TEND TO CONGREGATE. COMPREHENSIVE DENTAL AND BEHAVIORAL HEALTH SERVICES ARE PROVIDED AT OUR MAIN CLINIC. INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS HAVE UNIQUE HEALTH CARE NEEDS. THEY ARE AT HIGH-RISK OF CONTRACTING OR EXACERBATING SERIOUS HEALTH CONDITIONS AS A RESULT OF PROLONGED EXPOSURE TO SEVERE WEATHER AND REDUCED ACCESS TO HEALTH CARE. AS A RESULT, INDIVIDUALS ARE OFTEN TREATED AT LATER STAGES OF DISEASE AND HAVE HIGHER MORTALITY AND CHRONIC MORBIDITY THAN INDIVIDUALS WITH ACCESS TO CONSISTENT HEALTH CARE. AT OUR OUTREACH CLINICS, WE SEE MANY PATIENTS WHO HAVE CHRONIC ILLNESSES AND ACUTE HEALTH ISSUES. IN AN ATTEMPT TO REACH A GREATER NUMBER OF HOMELESS PERSONS WHO MAY NOT BE CONNECTED THROUGH SAFETY NET SERVICES, CARE ALLIANCE HAS ESTABLISHED COLLABORATIVE AGREEMENTS WITH VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY WHERE HOMELESS INDIVIDUALS TEND TO CONGREGATE SO THAT THEY MAY PROVIDE MEDICAL AND SUPPORTIVE CARE. THESE OUTREACH LOCATIONS INCLUDE: THE LUTHERAN METROPOLITAN MINISTRIES MEN'S SHELTER, NORMA HERR WOMEN'S SHELTER. BISHOP COSGROVE, WEST SIDE CATHOLIC CENTER, AND THE SALVATION ARMY ADULT REHABILITATION CENTER, AMONG OTHERS. THROUGH OUR OUTREACH PROGRAM, CARE ALLIANCE IS ABLE TO OFFER CLINICS THROUGHOUT THE CITY OF CLEVELANDWHERE INDIVIDUALS EXPERIENCING HOMELESSNESS MAY MEET TO OBTAIN A MEAL, SOCIAL SERVICES, A SHOWER, OR SHELTER. IN 2015, CARE ALLIANCE LAUNCHED A MOBILE CLINIC PROGRAM TO SERVE CHRONICALLY HOMELESS INDIVIDUALS LIVING IN PERMANENT SUPPORTIVE HOUSING. BY PROVIDING THESE SERVICES IN ENVIRONMENTS WHERE THESE INDIVIDUALS ARE COMFORTABLE, OUR OUTREACH STAFF ARE BETTER ABLE TO ENGAGE PATIENTS INTO CARE WITH THE LONG-TERM GOAL OF BRINGING THEM INTO ONE OF OUR PRIMARY CLINICS TO OBTAIN THE FULL SCOPE OF COMPREHENSIVE SERVICES NEEDED TO TRANSITION FROM HOMELESSNESS INTO STABLE HOUSING. CLIENTS SERVED = 2,216.</Desc>
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        <Desc>PUBLIC HOUSING PRIMARY CARE: RECOGNIZING THE NEED TO PROVIDE HIGH QUALITY AND ACCESSIBLE CARE TO A POPULATION VULNERABLE TO HEALTH DISPARITIES, AND IN AN EFFORT TO MAINTAIN OUR CARE RELATIONSHIPS AS OUR PATIENTS WERE HOUSED, IN 1998, CARE ALLIANCE APPLIED FOR AND RECEIVED FUNDING FROM HRSA TO PROVIDE MEDICAL AND DENTAL CARE SPECIFICALLY TO THOSE LIVING IN AND AROUND PUBLIC HOUSING. SINCE THAT TIME, CARE ALLIANCE HAS OPERATED ONE CLINIC WITHIN THE CUYAHOGA METROPOLITAN HOUSING AUTHORITY (CMHA) DEVELOPMENTS. THIS SPACE HAS ENABLED THE ORGANIZATION TO PROVIDE ITS SERVICES IN EASILY ACCESSIBLE LOCATION TO PUBLIC HOUSING RESIDENTS AND IN A CULTURALLY SENSITIVE MANNER. THE FACILITY IS LOCATED ON THE NEAR EAST SIDE OF THE CITY INSIDE CARL B. STOKES SOCIAL SERVICES MALL. AFTER THE RECENT RENOVATION OF OUR STOKES CLINIC, THE LOCATION OFFERS CARE ALLIANCE 34-1748776 PRIMARY MEDICAL AND PODIATRY SERVICES ACROSS THE LIFESPAN OF OUR PATIENT POPULATION. IN APRIL 2015, CARE ALLIANCE OPENED THE CENTRAL NEIGHBORHOOD CLINIC TO PROVIDE COMPREHENSIVE PRIMARY MEDICAL, BEHAVIORAL, PODIATRY, AND DENTAL SERVICES TO ADULTS AND CHILDREN LIVING IN CLEVELAND'S CENTRAL NEIGHBORHOOD, HOME TO THE HIGHEST CONCENTRATION OF PUBLIC HOUSING IN NORTHEAST OHIO. CLIENTS SERVED = 10,375.</Desc>
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        <Desc>HIV/AIDS: CARE ALLIANCE IS COMMITTED TO PROVIDING QUALITY HEALTH CARE TO UNDERSERVED POPULATIONS AT RISK FOR HEALTH DISPARITIES. AS SUCH, CARE ALLIANCE PROVIDES CARE TO PEOPLE LIVING WITH HIV/AIDS (PLWHA) THROUGH COMMUNITY-BASED AND IN-HOUSE HIV TESTING, COUNSELING, LINKAGE TO CARE, AND REFERRALS TO SUPPORTIVE SERVICES. IN AN EFFORT TO PROVIDE MEDICAL, DENTAL AND SUPPORTIVE SERVICES TO PLWHA, OUR TEAM WORKS TO MAINTAIN AND DEVELOP STRONG RELATIONSHIPS WITH HIV SERVICE PROVIDERS IN THE CLEVELAND AREA TO ENSURE A CONTINUUM OF CARE AND NON-DUPLICATION OF SERVICES. HIV TESTING, EDUCATION, AND MEDICAL CARE IS LOCATED AT OUR CENTRAL CLINIC, WHEN AN INDIVIDUAL SEEN IN THE CLINIC OR OUTREACH LOCATION TESTS POSITIVE FOR THE HIV VIRUS, HE OR SHE IS IMMEDIATELY LINKED TO CARE. INDIVIDUALS WHO TEST POSITIVE ARE INTRODUCED TO OUR OUTREACH WORKER FOR BASIC HIV EDUCATION AND DISCUSSION ABOUT THE IMPORTANCE OF CONSISTENT MEDICAL CARE AND MEDICATION REGIMENS. ALL NEW CARE ALLIANCE PATIENTS ARE SEEN BY THE CARE COORDINATOR FOR AN INITIAL ASSESSMENT TO UNDERSTAND THE NEED FOR SUPPORTIVE SERVICES. ONGOING SUPPORTIVE SERVICES INCLUDE PARTNER NOTIFICATION; MEDICAL EVALUATION AND ONGOING CARE; ADHERENCE EDUCATION; MEDICAL CASE MANAGEMENT AND ELIGIBILITY ASSISTANCE; SHORT-TERM MENTAL HEALTH AND SHORT-TERM SUBSTANCE ABUSE COUNSELING; SPECIALIZED CHRONIC ILLNESS CARE PATIENTS WITH CO-MORBIDITIES; ORAL HEALTH CARE SERVICES AND REFERRALS FOR ORAL SURGERY; AND ARE SCHEDULED WITH HIV SPECIALIST FOR TREATMENT.CARE ALLIANCE HAS ESTABLISHED PARTNERSHIPS WITH MANY SAFETY NET AGENCIES TO OFFER OUTREACH HIV TESTING AND BRIDGING SERVICES TO AT-RISK, UNAWARE OR OUT-OF-CARE POPULATIONS. IN 2022, THESE INCLUDED THE WEST SIDE CATHOLIC CENTER, NORMA HERR WOMEN'S SHELTER, STELLA MARIS, Y-HAVEN, AND LGBTQIA++ CENTER, AMONG OTHERS. IN CARE ALLIANCE'S ROLE AS THE PRIMARY CARE HOME FOR MANY OF CLEVELAND'S UNDERSERVED POPULATIONS, THE ORGANIZATION STRIVES TO ENSURE THAT PATIENTS STAY IN CARE, UTILIZE ALL APPROPRIATE SERVICES, AND COMPLY WITH TREATMENT REGIMENS TO MAINTAIN HEALTH AND WELL-BEING. CLIENTS SERVED = 88.</Desc>
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        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MECCA EAST MPH</PersonNm>
        <TitleTxt>VICE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL G EVANS CPA</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RANDALL KENNEDY</PersonNm>
        <TitleTxt>OUTGOING BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RENEE TRAMBLE RICHARD</PersonNm>
        <TitleTxt>BOARD CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANDRA FLEMING-BROOKS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHANNON FOGERTY JERSE ESQ</PersonNm>
        <TitleTxt>OUTGOING VICE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANTHONY FELICI</PersonNm>
        <TitleTxt>OUTGOING CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>87669</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11284</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLAUDE L JONES</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>467088</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41271</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL FINCH</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>71934</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10556</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHINEZE ENWONWU</PersonNm>
        <TitleTxt>CHIEF DENTAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>137886</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16472</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID SIEGEL</PersonNm>
        <TitleTxt>CHIEF IT OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>121333</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7964</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DORIS WILLIAMS</PersonNm>
        <TitleTxt>CHIEF OPERATING OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>187007</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21377</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JASMINA SARIC</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>117198</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24607</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHIVANI B JOSHI</PersonNm>
        <TitleTxt>PHYSICIAN - PEDIATRIC</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>154046</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11553</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1344161</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>145084</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>9</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JANITORIAL SERVICES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4830 E 49TH STREET</AddressLine1Txt>
            <CityNm>CLEVELAND</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44125</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>JANITORIAL SERVICES</ServicesDesc>
        <CompensationAmt>217821</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SHANAHAN LAW FIRM</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1111 CHESTER AVE STE 530</AddressLine1Txt>
            <CityNm>GOSHEN</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10924</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LEGAL SERVICES</ServicesDesc>
        <CompensationAmt>125260</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>2</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>6566569</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>156750</AllOtherContributionsAmt>
      <NoncashContributionsAmt>82150</NoncashContributionsAmt>
      <TotalContributionsAmt>6723319</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAID</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>3270683</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3270683</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>340B PHARMACY REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>2250862</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2250862</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>419267</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>419267</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER THIRD PARTY</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>321956</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>321956</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SELF-PAY</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>43413</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>43413</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>6306181</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>93983</TotalRevenueColumnAmt>
        <ExclusionAmt>93983</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>36000</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>36000</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>36000</TotalRevenueColumnAmt>
        <ExclusionAmt>36000</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1095461</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>1135409</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-39948</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-39948</TotalRevenueColumnAmt>
        <ExclusionAmt>-39948</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>QUALITY INCENT. PYMTS</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>425424</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>425424</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>137094</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>137094</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>562518</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>13682053</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6868699</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>90035</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>619199</TotalAmt>
        <ProgramServicesAmt>462527</ProgramServicesAmt>
        <ManagementAndGeneralAmt>154173</ManagementAndGeneralAmt>
        <FundraisingAmt>2499</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>4929556</TotalAmt>
        <ProgramServicesAmt>3682267</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1227398</ManagementAndGeneralAmt>
        <FundraisingAmt>19891</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>169728</TotalAmt>
        <ProgramServicesAmt>126783</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42260</ManagementAndGeneralAmt>
        <FundraisingAmt>685</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>375672</TotalAmt>
        <ProgramServicesAmt>280619</ProgramServicesAmt>
        <ManagementAndGeneralAmt>93538</ManagementAndGeneralAmt>
        <FundraisingAmt>1515</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>428677</TotalAmt>
        <ProgramServicesAmt>320212</ProgramServicesAmt>
        <ManagementAndGeneralAmt>106735</ManagementAndGeneralAmt>
        <FundraisingAmt>1730</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>251486</TotalAmt>
        <ManagementAndGeneralAmt>251486</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>51168</TotalAmt>
        <ManagementAndGeneralAmt>51168</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>12286</TotalAmt>
        <ManagementAndGeneralAmt>12286</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1792149</TotalAmt>
        <ProgramServicesAmt>1537411</ProgramServicesAmt>
        <ManagementAndGeneralAmt>254738</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>406770</TotalAmt>
        <ProgramServicesAmt>22384</ProgramServicesAmt>
        <ManagementAndGeneralAmt>300189</ManagementAndGeneralAmt>
        <FundraisingAmt>84197</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>89526</TotalAmt>
        <ProgramServicesAmt>78513</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9149</ManagementAndGeneralAmt>
        <FundraisingAmt>1864</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>87166</TotalAmt>
        <ProgramServicesAmt>41862</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44142</ManagementAndGeneralAmt>
        <FundraisingAmt>1162</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>679070</TotalAmt>
        <ProgramServicesAmt>592490</ProgramServicesAmt>
        <ManagementAndGeneralAmt>60858</ManagementAndGeneralAmt>
        <FundraisingAmt>25722</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>33924</TotalAmt>
        <ProgramServicesAmt>18302</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15622</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>37992</TotalAmt>
        <ProgramServicesAmt>20497</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17495</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>408976</TotalAmt>
        <ProgramServicesAmt>318104</ProgramServicesAmt>
        <ManagementAndGeneralAmt>90872</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>91145</TotalAmt>
        <ProgramServicesAmt>76942</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10652</ManagementAndGeneralAmt>
        <FundraisingAmt>3551</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACY SUPPLIES</Desc>
        <TotalAmt>1071512</TotalAmt>
        <ProgramServicesAmt>1071512</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>477621</TotalAmt>
        <ProgramServicesAmt>386429</ProgramServicesAmt>
        <ManagementAndGeneralAmt>87181</ManagementAndGeneralAmt>
        <FundraisingAmt>4011</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>139012</TotalAmt>
        <ProgramServicesAmt>108100</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26546</ManagementAndGeneralAmt>
        <FundraisingAmt>4366</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>100812</TotalAmt>
        <ProgramServicesAmt>70241</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27943</ManagementAndGeneralAmt>
        <FundraisingAmt>2628</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>317126</TotalAmt>
        <ProgramServicesAmt>232249</ProgramServicesAmt>
        <ManagementAndGeneralAmt>76889</ManagementAndGeneralAmt>
        <FundraisingAmt>7988</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>12570573</TotalAmt>
        <ProgramServicesAmt>9447444</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2961320</ManagementAndGeneralAmt>
        <FundraisingAmt>161809</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3882594</BOYAmt>
        <EOYAmt>5369650</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>487727</BOYAmt>
        <EOYAmt>623142</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>694151</BOYAmt>
        <EOYAmt>302114</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>805392</BOYAmt>
        <EOYAmt>1143485</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>129639</BOYAmt>
        <EOYAmt>121823</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>28800</BOYAmt>
        <EOYAmt>57254</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>8773456</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4655453</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>4091257</BOYAmt>
        <EOYAmt>4118003</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>2083684</BOYAmt>
        <EOYAmt>2139241</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <TotalAssetsGrp>
        <BOYAmt>12203244</BOYAmt>
        <EOYAmt>13874712</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>828556</BOYAmt>
        <EOYAmt>1345968</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>48667</BOYAmt>
        <EOYAmt>48667</EOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>217176</BOYAmt>
        <EOYAmt>217176</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>1094399</BOYAmt>
        <EOYAmt>1611811</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>11026619</BOYAmt>
        <EOYAmt>12208439</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>82226</BOYAmt>
        <EOYAmt>54462</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>11108845</BOYAmt>
        <EOYAmt>12262901</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>12203244</BOYAmt>
        <EOYAmt>13874712</EOYAmt>
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