﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2023v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-11-15T11:22:52-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>473999292</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CUOMO WINTERS &amp; SCHMIDT CPAS PLLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>6315 FLY RD STE 108</AddressLine1Txt>
        <CityNm>EAST SYRACUSE</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>130579316</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>161134413</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MOHAWK VALLEY AMBULANCE CORPS INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>MOHA</BusinessNameControlTxt>
      <PhoneNum>3158662336</PhoneNum>
      <USAddress>
        <AddressLine1Txt>15 STATE ROUTE 5S</AddressLine1Txt>
        <CityNm>MOHAWK</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>13407</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>KELLY BROWN</PersonNm>
      <PersonTitleTxt>BUSINESS MANAGER</PersonTitleTxt>
      <PhoneNum>3158662336</PhoneNum>
      <SignatureDt>2024-11-15</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>false</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>MARK STRONG CPA</PreparerPersonNm>
      <PTIN>P00294127</PTIN>
      <PhoneNum>3154710465</PhoneNum>
      <PreparationDt>2024-11-15</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2024-10-15 13:58:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="4">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc4">
      <PrincipalOfficerNm>ROBERT DRUMM</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>15 STATE ROUTE 5S</AddressLine1Txt>
        <CityNm>MOHAWK</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>13407</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>2861202</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.MOVAC.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1979</FormationYr>
      <LegalDomicileStateCd>NY</LegalDomicileStateCd>
      <ActivityOrMissionDesc>AMBULANCE AND MEDICAL ASSISTANCE SERVICES TO RESIDENTS OF MOHAWK VALLEY REGION</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>9</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>77</TotalEmployeeCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>105780</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>189562</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>2653756</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>2671265</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>24</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>30</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>200</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>345</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>2759760</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>2861202</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>1769969</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1983090</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>10544</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>1001762</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>1052136</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>2771731</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>3035226</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-11971</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-174024</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>1098901</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>1008040</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>462941</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>546104</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>635960</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>461936</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>AMBULANCE AND EMERGENCY MEDICAL SERVICES TO THE MOHAWK VALLEY REGION OF NEW YORK STATE.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>2898840</ExpenseAmt>
      <Desc>AMBULANCE AND EMERGENCY MEDICAL SERVICES TO THE MOHAWK VALLEY REGION OF NEW YORK STATE.</Desc>
      <TotalProgramServiceExpensesAmt>2898840</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc5">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc3">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc3">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc3">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc3">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc3">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc3">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc3">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc3">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc3">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc3">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc3">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc3">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc3">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>false</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>1</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>false</BackupWthldComplianceInd>
      <EmployeeCnt>77</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>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>9</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>false</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>false</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>false</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <OtherWebsiteInd>X</OtherWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>KELLY BROWN</PersonNm>
        <PhoneNum>3158662336</PhoneNum>
        <USAddress>
          <AddressLine1Txt>15 STATE ROUTE 5S</AddressLine1Txt>
          <CityNm>MOHAWK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13407</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>RAYMOND BRUNETTE</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HEIDI CAMARDELLO</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GEORGE COMSTOCK</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT DRUMM</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATRICK LAPORTE</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID RONAN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THEA SCALICE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELENA SCALISE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID YANNEY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>false</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <GovernmentGrantsAmt>70841</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>118721</AllOtherContributionsAmt>
      <TotalContributionsAmt>189562</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>AMBULANCE SERVICES</Desc>
        <BusinessCd>621910</BusinessCd>
        <TotalRevenueColumnAmt>2384836</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2384836</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACTED SERVICES</Desc>
        <TotalRevenueColumnAmt>275589</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>275589</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>TRANSPORT</Desc>
        <TotalRevenueColumnAmt>10840</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10840</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>2671265</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>30</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>30</RelatedOrExemptFuncIncomeAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER INCOME</Desc>
        <BusinessCd>621910</BusinessCd>
        <TotalRevenueColumnAmt>345</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>345</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>345</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>2861202</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2671640</RelatedOrExemptFuncIncomeAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>1675935</TotalAmt>
        <ProgramServicesAmt>1608730</ProgramServicesAmt>
        <ManagementAndGeneralAmt>67205</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>14868</TotalAmt>
        <ProgramServicesAmt>14272</ProgramServicesAmt>
        <ManagementAndGeneralAmt>596</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>155294</TotalAmt>
        <ProgramServicesAmt>148927</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6367</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>136993</TotalAmt>
        <ProgramServicesAmt>131500</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5493</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>16099</TotalAmt>
        <ManagementAndGeneralAmt>16099</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>28014</TotalAmt>
        <ManagementAndGeneralAmt>28014</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>4032</TotalAmt>
        <ProgramServicesAmt>4032</ProgramServicesAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>46423</TotalAmt>
        <ProgramServicesAmt>46423</ProgramServicesAmt>
      </OccupancyGrp>
      <InterestGrp>
        <TotalAmt>13650</TotalAmt>
        <ProgramServicesAmt>13650</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>92593</TotalAmt>
        <ProgramServicesAmt>92593</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>290009</TotalAmt>
        <ProgramServicesAmt>290009</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>VEHICLE EXPENSES</Desc>
        <TotalAmt>213553</TotalAmt>
        <ProgramServicesAmt>213553</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL BILLING</Desc>
        <TotalAmt>138044</TotalAmt>
        <ProgramServicesAmt>138044</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL EQUIPMENT</Desc>
        <TotalAmt>103345</TotalAmt>
        <ProgramServicesAmt>103345</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>57832</TotalAmt>
        <ProgramServicesAmt>57832</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>48542</TotalAmt>
        <ProgramServicesAmt>35930</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2068</ManagementAndGeneralAmt>
        <FundraisingAmt>10544</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>3035226</TotalAmt>
        <ProgramServicesAmt>2898840</ProgramServicesAmt>
        <ManagementAndGeneralAmt>125842</ManagementAndGeneralAmt>
        <FundraisingAmt>10544</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>64204</BOYAmt>
        <EOYAmt>56192</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>11700</BOYAmt>
        <EOYAmt>17142</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>277587</BOYAmt>
        <EOYAmt>256388</EOYAmt>
      </AccountsReceivableGrp>
      <LandBldgEquipCostOrOtherBssAmt>1557395</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>879237</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>745250</BOYAmt>
        <EOYAmt>678158</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>160</BOYAmt>
        <EOYAmt>160</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>1098901</BOYAmt>
        <EOYAmt>1008040</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>219326</BOYAmt>
        <EOYAmt>422715</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>218615</BOYAmt>
        <EOYAmt>98389</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>25000</BOYAmt>
        <EOYAmt>25000</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>462941</BOYAmt>
        <EOYAmt>546104</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>635960</BOYAmt>
        <EOYAmt>461936</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>635960</BOYAmt>
        <EOYAmt>461936</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>1098901</BOYAmt>
        <EOYAmt>1008040</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-174024</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc5">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>28734</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>148026</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>328608</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>105780</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>189562</CurrentTaxYearAmt>
        <TotalAmt>800710</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>1993054</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2171993</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2033179</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2653980</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2671640</CurrentTaxYearAmt>
        <TotalAmt>11523846</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>2021788</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2320019</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2361787</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2759760</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2861202</CurrentTaxYearAmt>
        <TotalAmt>12324556</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>12324556</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>7</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>107</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>80</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>30</CurrentTaxYearAmt>
        <TotalAmt>248</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>7</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>107</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>80</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>30</CurrentTaxYearAmt>
        <TotalAmt>248</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <CurrentTaxYearMinus2YearsAmt>3936</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>3936</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>2021795</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2320126</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2365803</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2759784</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2861232</CurrentTaxYearAmt>
        <TotalAmt>12328740</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99970</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99960</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc3">
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>44489</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>16313</DepreciationAmt>
        <BookValueAmt>28176</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>111476</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>97408</DepreciationAmt>
        <BookValueAmt>14068</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1401429</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>765515</DepreciationAmt>
        <BookValueAmt>635914</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>678158</TotalBookValueLandBuildingsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc4">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS ELECT THE MEMBERS OF THE GOVERNING BODY OR THEIR DELEGATES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>OFFICERS ARE ELECTED BY THE MEMBERS. THE TOWN REPS ARE APPOINTED BY LOCAL MAYORS AND TOWN SUPERVISORS. THE MEDICAL DIRECTOR IS APPOINTED BY THE BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE COMMITTEE MEETS WITH TAX PREPARER TO GO OVER THE RETURN AND ASK QUESTIONS IF NECESSARY. THE BOARD THEN REVIEWS THE RETURN AND VOTES FOR APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ANY OFFICERS, DIRECTORS OR KEY EMPLOYEES THAT HAVE THE DUTY TO DISCLOSE CONFLICTS OF INTEREST IF THEY ARISE. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AND OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL DOCUMENTS ARE DISCLOSED UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>