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        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>176464</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42298</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HEATHER LEBEAU</PersonNm>
        <TitleTxt>VP FINANCE/HUMAN RESOURCE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>160439</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45449</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MANUEL MARTIN</PersonNm>
        <TitleTxt>VP COMMERICAL SERVICES</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>165860</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34481</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EMILY NELSON</PersonNm>
        <TitleTxt>VP HEALTHCARE TRANSFORMATION</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>164900</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>51885</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KARL STEBBINS</PersonNm>
        <TitleTxt>DIRECTOR OF INFO. TECH</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>173798</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41879</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1383920</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>328141</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>18</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>POORNIMA DABIR</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>9424 CARRIAGE HILL DR</AddressLine1Txt>
            <CityNm>FREDERICK</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21704</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>URAC AUDIT CONSULTANT</ServicesDesc>
        <CompensationAmt>214435</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SAUK COUNTY PUBLIC HEALTH</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>505 BROADWAY ST NO 372</AddressLine1Txt>
            <CityNm>BARABOO</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53913</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HRSA CONSULTANTS</ServicesDesc>
        <CompensationAmt>171000</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>STEVEN BRISKI LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5251 SNAPDRAGON TRAIL</AddressLine1Txt>
            <CityNm>FITCHBURG</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53711</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT CONSULTING</ServicesDesc>
        <CompensationAmt>168591</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ELEVATE MEDICAL SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 24</AddressLine1Txt>
            <CityNm>KELLIHER</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>56650</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ERQ CONSULTANTS</ServicesDesc>
        <CompensationAmt>167721</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ROSS SEGEL</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>731 LAKE RIDGE DRIVE</AddressLine1Txt>
            <CityNm>SOUTH ELGIN</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60177</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEDIS, DV AND MEDICAID CONSULTING</ServicesDesc>
        <CompensationAmt>166525</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>LONG TERM CARE CONTRACT</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>3052638</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3052638</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PERFORMANCE MEASUREMENT REVIEWS</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>3045140</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3045140</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>FEDERAL MEDICARE CONTRACT</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>2823002</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2823002</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>WIS MEDICAID CONTRACT</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>1668312</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1668312</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER GRANTS</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>1449464</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1449464</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>12792</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>12792</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>12051348</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>134931</TotalRevenueColumnAmt>
        <ExclusionAmt>134931</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>338955</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>238738</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>100217</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>100217</TotalRevenueColumnAmt>
        <ExclusionAmt>100217</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>ADMINISTRATIVE - SHQA</Desc>
        <BusinessCd>900001</BusinessCd>
        <TotalRevenueColumnAmt>283519</TotalRevenueColumnAmt>
        <ExclusionAmt>283519</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>283519</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>12570015</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>12051348</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>518667</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>654607</TotalAmt>
        <ProgramServicesAmt>69019</ProgramServicesAmt>
        <ManagementAndGeneralAmt>585588</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6056700</TotalAmt>
        <ProgramServicesAmt>4593548</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1463152</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>656377</TotalAmt>
        <ProgramServicesAmt>458978</ProgramServicesAmt>
        <ManagementAndGeneralAmt>197399</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1307614</TotalAmt>
        <ProgramServicesAmt>914362</ProgramServicesAmt>
        <ManagementAndGeneralAmt>393252</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>484023</TotalAmt>
        <ProgramServicesAmt>338458</ProgramServicesAmt>
        <ManagementAndGeneralAmt>145565</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>10659</TotalAmt>
        <ManagementAndGeneralAmt>10659</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>61728</TotalAmt>
        <ProgramServicesAmt>11000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>50728</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>116237</TotalAmt>
        <ProgramServicesAmt>30719</ProgramServicesAmt>
        <ManagementAndGeneralAmt>85518</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>58638</TotalAmt>
        <ProgramServicesAmt>17982</ProgramServicesAmt>
        <ManagementAndGeneralAmt>40656</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>210770</TotalAmt>
        <ProgramServicesAmt>70674</ProgramServicesAmt>
        <ManagementAndGeneralAmt>140096</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>83352</TotalAmt>
        <ProgramServicesAmt>40918</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42434</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>59355</TotalAmt>
        <ProgramServicesAmt>28431</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30924</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>10</TotalAmt>
        <ProgramServicesAmt>10</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>24414</TotalAmt>
        <ManagementAndGeneralAmt>24414</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>62280</TotalAmt>
        <ManagementAndGeneralAmt>62280</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUBCONTRACTORS</Desc>
        <TotalAmt>1587921</TotalAmt>
        <ProgramServicesAmt>1538678</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49243</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER COSTS</Desc>
        <TotalAmt>284285</TotalAmt>
        <ProgramServicesAmt>101234</ProgramServicesAmt>
        <ManagementAndGeneralAmt>183051</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSE &amp; CERTIFICATION</Desc>
        <TotalAmt>119420</TotalAmt>
        <ProgramServicesAmt>118481</ProgramServicesAmt>
        <ManagementAndGeneralAmt>939</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DATA PROCESSING</Desc>
        <TotalAmt>113629</TotalAmt>
        <ProgramServicesAmt>6957</ProgramServicesAmt>
        <ManagementAndGeneralAmt>106672</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>11952019</TotalAmt>
        <ProgramServicesAmt>8339449</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3612570</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>4408067</BOYAmt>
        <EOYAmt>3177373</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <EOYAmt>1550012</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2405834</BOYAmt>
        <EOYAmt>2749823</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>356353</BOYAmt>
        <EOYAmt>329040</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>5748892</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3807376</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1910242</BOYAmt>
        <EOYAmt>1941516</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>9080496</BOYAmt>
        <EOYAmt>9747764</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1504350</BOYAmt>
        <EOYAmt>1564858</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>20039</BOYAmt>
        <EOYAmt>8803</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>1524389</BOYAmt>
        <EOYAmt>1573661</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>7556107</BOYAmt>
        <EOYAmt>8174103</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>7556107</BOYAmt>
        <EOYAmt>8174103</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>9080496</BOYAmt>
        <EOYAmt>9747764</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>617996</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>12426767</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>11505789</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12035992</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11164637</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12051348</CurrentTaxYearAmt>
        <TotalAmt>59184533</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>12426767</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>11505789</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12035992</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11164637</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12051348</CurrentTaxYearAmt>
        <TotalAmt>59184533</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>59184533</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>268597</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>254563</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>282672</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>283551</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>473886</CurrentTaxYearAmt>
        <TotalAmt>1563269</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>268597</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>254563</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>282672</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>283551</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>473886</CurrentTaxYearAmt>
        <TotalAmt>1563269</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>451843</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>282170</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>188201</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>222780</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>283519</CurrentTaxYearAmt>
        <TotalAmt>1428513</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>13147207</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12042522</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12506865</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11670968</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12808753</CurrentTaxYearAmt>
        <TotalAmt>62176315</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.95190</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.95980</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.02510</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.02170</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>ADMINISTRATIVE SERVICES FOR RELATED ORGANIZATION - 2019 AMOUNT: $ 451,843. 2020 AMOUNT: $ 282,170. 2021 AMOUNT: $ 188,121. 2022 AMOUNT: $ 222,780. 2023 AMOUNT: $ 283,519. MISCELLANEOUS REVENUE - 2021 AMOUNT: $ 80.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>405880</OtherCostOrOtherBasisAmt>
        <BookValueAmt>405880</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>5061680</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3606211</DepreciationAmt>
        <BookValueAmt>1455469</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>281332</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>201165</DepreciationAmt>
        <BookValueAmt>80167</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>1941516</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>12808753</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>238738</OtherRevenueAmt>
      <RevenueNotReportedAmt>238738</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>12570015</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>12570015</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>12190757</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>238738</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>238738</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>11952019</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>11952019</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS A TAX-EXEMPT, NON-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THERE ARE NO DEFERRED INCOME TAXES RESULTING FROM TIMING DIFFERENCES BETWEEN FINANCIAL AND TAX ACCOUNTING. THE ORGANIZATION PAID $0 IN TAXES FOR THE YEARS ENDING DECEMBER 31, 2023 AND 2022. THE ORGANIZATION HAD NO MATERIAL UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2023 AND 2022. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2020 FOR FEDERAL PURPOSES AND 2019 FOR STATE PURPOSES. THE ORGANIZATION IS NOT CURRENTLY UNDER EXAMINATION BY ANY TAXING JURISDICTIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES 238,738.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES 238,738.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
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        <PersonNm>PAUL NEITZEL</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EMILY NELSON</PersonNm>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KARL STEBBINS</PersonNm>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>215677</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HEATHER LEBEAU</PersonNm>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MANUEL MARTIN</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HUMAN RESOURCES MANAGER ANNUALLY PROVIDES COMPENSATION SURVEY DATA TO THE COMPENSATION COMMITTEE &amp; BOARD FOR REVIEW AND APPROVAL.</ExplanationTxt>
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    </IRS990ScheduleJ>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CFO AND TREASURER REVIEWS THE ENTIRE 990 BEFORE THE RETURN IS SIGNED AND SUBMITTED. THE RETURN IS MADE AVAILABLE TO THE FINANCE COMMITTEE AND BOARD TO REVIEW AS WELL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUALLY, THE CCO HAS THE BOARD OF DIRECTORS AND EMPLOYEES READ THE APPLICABLE CONFLICT OF INTEREST POLICY AND ATTEST THAT THEY UNDERSTAND IT AND ARE IN COMPLIANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>PER ITS EXECUTIVE LIMITATION POLICY LP6, THE FULL BOARD OF TRUSTEES APPROVES THE CEO COMPENSATION ANNUALLY. ALL OTHER EMPLOYEES RECEIVE THE SAME COST OF LIVING AND MERIT INCREASE PERCENT ANNUALLY. EVERY TWO OR THREE YEARS, THE HUMAN RESOURCES DEPARTMENT COMPARES LOCAL AND LIKE INDUSTRY SURVEYS TO STAFF SALARIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>A COPY OF THE DOCUMENT IS MADE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS OF OVERSEEING THE AUDIT BY THE COMMITTEE HAS NOT CHANGED THIS PAST CALENDAR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        </DisregardedEntityName>
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          <AddressLine1Txt>2909 LANDMARK PLACE</AddressLine1Txt>
          <CityNm>MADISON</CityNm>
          <StateAbbreviationCd>WI</StateAbbreviationCd>
          <ZIPCd>53713</ZIPCd>
        </USAddress>
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        <PrimaryActivitiesTxt>HEALTH CARE QUALITY IMPROVEMENT</PrimaryActivitiesTxt>
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      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
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</Return>