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        <TotalAmt>459558</TotalAmt>
        <ProgramServicesAmt>459558</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>UNCOLLECTIBLE ACCOUNTS</Desc>
        <TotalAmt>415587</TotalAmt>
        <ProgramServicesAmt>415587</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PATIENT SUPPLIES</Desc>
        <TotalAmt>176690</TotalAmt>
        <ProgramServicesAmt>176690</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>611570</TotalAmt>
        <ProgramServicesAmt>611570</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>7652256</TotalAmt>
        <ProgramServicesAmt>7102581</ProgramServicesAmt>
        <ManagementAndGeneralAmt>549675</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>99274</BOYAmt>
        <EOYAmt>58835</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1100734</BOYAmt>
        <EOYAmt>352989</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1234031</BOYAmt>
        <EOYAmt>1260625</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>66560</BOYAmt>
        <EOYAmt>55195</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <LandBldgEquipCostOrOtherBssAmt>6745544</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3355362</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>2808928</BOYAmt>
        <EOYAmt>3390182</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>5309527</BOYAmt>
        <EOYAmt>5117826</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>262772</BOYAmt>
        <EOYAmt>376470</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>37320</BOYAmt>
        <EOYAmt>-45459</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>343249</BOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>643341</BOYAmt>
        <EOYAmt>331011</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>4666186</BOYAmt>
        <EOYAmt>4786815</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>4666186</BOYAmt>
        <EOYAmt>4786815</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>5309527</BOYAmt>
        <EOYAmt>5117826</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>120629</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>true</AccountantCompileOrReviewInd>
      <AcctCompileOrReviewBasisGrp>
        <ConsolAndSepBasisFinclStmtInd>X</ConsolAndSepBasisFinclStmtInd>
      </AcctCompileOrReviewBasisGrp>
      <FSAuditedInd>false</FSAuditedInd>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="990A">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>108000</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>884560</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>348800</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>172436</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>99507</CurrentTaxYearAmt>
        <TotalAmt>1613303</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>5179793</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4716326</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5818687</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7263801</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7665993</CurrentTaxYearAmt>
        <TotalAmt>30644600</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>5287793</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5600886</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6167487</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7436237</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7765500</CurrentTaxYearAmt>
        <TotalAmt>32257903</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>32257903</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>369</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>445</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>658</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>344</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7384</CurrentTaxYearAmt>
        <TotalAmt>9200</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>369</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>445</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>658</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>344</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7384</CurrentTaxYearAmt>
        <TotalAmt>9200</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>5288162</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5601331</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6168145</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7436581</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7772884</CurrentTaxYearAmt>
        <TotalAmt>32267103</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99970</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99990</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="990D">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>295616</OtherCostOrOtherBasisAmt>
        <BookValueAmt>295616</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>3010313</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1115251</DepreciationAmt>
        <BookValueAmt>1895062</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <DepreciationAmt>60823</DepreciationAmt>
        <BookValueAmt>-60823</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3439615</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2179288</DepreciationAmt>
        <BookValueAmt>1260327</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>3390182</TotalBookValueLandBuildingsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="990O">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 governing body review Part VI line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990 IS PRESENTED TO THE MANAGEMENT AND BOARD PRIOR TO FILING</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Conflict of interest policy compliance Part VI line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS ARE ALWAYS REMINDED OF CONFLICT OF INTEREST REQUIREMENTS. IN FACT, NOW ONE IS ADDED TO THE BOARD WHO COULD HAVE POSSIBLE CONFLICT ISSUES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>CEO executive director top management comp Part VI line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD DETERMINES COMPENSATION OF THE MANAGING DIRECTOR VIA REVIEWS OF SIMILAR SIZED NON-PROFIT ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other officer or key employee compensation Part VI line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGING DIRECTOR AND BOARD REVIEW COMPARABLE POSITIONS IN OTHER SIMILAR ORGANIZATIONS AS WELL AS EMPLOYEE PERFORMANCE AND VALUE TO THE COMPANY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 availability to public Part VI line 18</FormAndLineReferenceDesc>
        <ExplanationTxt>990S ARE AVAILABLE AT THE MAIN OFFICE OF ROCKFORD AMBULANCE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Governing documents etc available to public Part VI line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>BY LAWS AS WELL AS THE 990S ARE AVAILABLE AT THE MAIN OFFICE; 8560 SHANER, ROCKFORD MI 49341</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>