﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2024v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-11-17T11:46:01-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>203767687</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>HHH CPA GROUP LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1250 OLD HENDERSON RD</AddressLine1Txt>
        <CityNm>COLUMBUS</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>43220</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>311275735</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>AHFCENTRAL STATES INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>AHFC</BusinessNameControlTxt>
      <PhoneNum>6147607352</PhoneNum>
      <USAddress>
        <AddressLine1Txt>5920 VENTURE DR RM/STE 100</AddressLine1Txt>
        <CityNm>DUBLIN</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>43017</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>J MICHAEL HAEMMERLE</PersonNm>
      <PersonTitleTxt>TREASURER/SECRETARY</PersonTitleTxt>
      <PhoneNum>6147607352</PhoneNum>
      <SignatureDt>2025-10-21</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>false</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>BRIAN SCHNEIDER</PreparerPersonNm>
      <PTIN>P01394250</PTIN>
      <PhoneNum>6144514644</PhoneNum>
      <PreparationDt>2025-11-14</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1" referenceDocumentId="RetDoc4">
      <PrincipalOfficerNm>J MICHAEL HAEMMERLE</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>5920 VENTURE DR STE 100</AddressLine1Txt>
        <CityNm>DUBLIN</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>43017</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>11037964</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1988</FormationYr>
      <LegalDomicileStateCd>OH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>AHF/CENTRAL STATES, INC. IS A NON-PROFIT ORGANIZATION WHICH OWNS AND OPERATES NURSING HOMES PROVIDING LOW-COST, LONG-TERM CARE FOR RESIDENTS.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>6</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>1</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>142</TotalEmployeeCnt>
      <TotalVolunteersCnt>4</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>9112559</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>9433311</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>91663</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>157244</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>9204222</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>9590555</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>4694076</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>4848377</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>5376987</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>5971662</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>10071063</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>10820039</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-866841</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1229484</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>8306193</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>7299152</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>5207819</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>5587507</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>3098374</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>1711645</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>AHF/CENTRAL STATES, INC. IS A NON-PROFIT ORGANIZATION WHICH OWNS AND OPERATES NURSING HOMES PROVIDING LOW-COST, LONG-TERM CARE FOR RESIDENTS.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>10817139</ExpenseAmt>
      <Desc>OPERATES A NURSING HOME PROVIDING LOW-COST, LONG-TERM CARE FOR RESIDENTS.</Desc>
      <TotalProgramServiceExpensesAmt>10817139</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc6">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc2">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc2">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc2">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc2">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc2">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc2">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc2">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc2">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc2">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc2">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc2">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc2">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc2">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 referenceDocumentId="RetDoc3">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc5">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc5">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc5">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc5">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>18</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>142</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>6</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>1</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>true</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>true</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>OH</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>JEFF HAEMMERLE</PersonNm>
        <PhoneNum>6147607352</PhoneNum>
        <USAddress>
          <AddressLine1Txt>5920 VENTURE DRIVE SUITE 100</AddressLine1Txt>
          <CityNm>DUBLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43017</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUZANNE M LEHMAN</PersonNm>
        <TitleTxt>PRESDIENT-MG</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>364900</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>37710</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>J MICHAEL HAEMMERLE</PersonNm>
        <TitleTxt>TREASURER/SE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>266423</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27297</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARIAMMA VARKEY</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>185550</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DINAH BEERCK</PersonNm>
        <TitleTxt>REGIONA; QA</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>171733</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6486</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATT LEHMAN</PersonNm>
        <TitleTxt>VP OF OPS</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>156210</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18973</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT MAYO</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>140507</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13968</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN WESLEY RAMSEY</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>128868</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25163</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFFREY D HAEMMERLE</PersonNm>
        <TitleTxt>TREASURER/SE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>105843</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26887</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY LEHMAN</PersonNm>
        <TitleTxt>OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>38.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>2900</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>101939</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN M HAEMMERLE</PersonNm>
        <TitleTxt>CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>60000</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK T HAEMMERLE</PersonNm>
        <TitleTxt>PRESIDENT/SE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>10.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES MCDONOUGH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2900</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>1681973</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>156484</TotalOtherCompensationAmt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <TotalRevenueColumnAmt>9433311</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9433311</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>9433311</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>89193</TotalRevenueColumnAmt>
        <ExclusionAmt>89193</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1515460</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>1447409</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>68051</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>68051</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>68051</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>9590555</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9501362</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>89193</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2900</TotalAmt>
        <ManagementAndGeneralAmt>2900</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>4032245</TotalAmt>
        <ProgramServicesAmt>4032245</ProgramServicesAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>33708</TotalAmt>
        <ProgramServicesAmt>33708</ProgramServicesAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>409556</TotalAmt>
        <ProgramServicesAmt>409556</ProgramServicesAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>369968</TotalAmt>
        <ProgramServicesAmt>369968</ProgramServicesAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>458432</TotalAmt>
        <ProgramServicesAmt>458432</ProgramServicesAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>125966</TotalAmt>
        <ProgramServicesAmt>125966</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>26345</TotalAmt>
        <ProgramServicesAmt>26345</ProgramServicesAmt>
      </AdvertisingGrp>
      <OccupancyGrp>
        <TotalAmt>260540</TotalAmt>
        <ProgramServicesAmt>260540</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>61126</TotalAmt>
        <ProgramServicesAmt>61126</ProgramServicesAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>161055</TotalAmt>
        <ProgramServicesAmt>161055</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>229202</TotalAmt>
        <ProgramServicesAmt>229202</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>240270</TotalAmt>
        <ProgramServicesAmt>240270</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CONSULTANTS</Desc>
        <TotalAmt>1964689</TotalAmt>
        <ProgramServicesAmt>1964689</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BED TAX</Desc>
        <TotalAmt>933482</TotalAmt>
        <ProgramServicesAmt>933482</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MED NRS &amp; ACTV SUPPLY</Desc>
        <TotalAmt>329310</TotalAmt>
        <ProgramServicesAmt>329310</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FOOD &amp; DIETARY</Desc>
        <TotalAmt>326099</TotalAmt>
        <ProgramServicesAmt>326099</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>855146</TotalAmt>
        <ProgramServicesAmt>855146</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>10820039</TotalAmt>
        <ProgramServicesAmt>10817139</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2900</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>743722</BOYAmt>
        <EOYAmt>481795</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>3982891</BOYAmt>
        <EOYAmt>3054726</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>856775</BOYAmt>
        <EOYAmt>1300721</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>27185</BOYAmt>
        <EOYAmt>27185</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>130325</BOYAmt>
        <EOYAmt>140507</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>9468502</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>7741044</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1847090</BOYAmt>
        <EOYAmt>1727458</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>149890</BOYAmt>
        <EOYAmt>143026</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>568315</BOYAmt>
        <EOYAmt>423734</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>8306193</BOYAmt>
        <EOYAmt>7299152</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1464384</BOYAmt>
        <EOYAmt>1961348</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>3713161</BOYAmt>
        <EOYAmt>3592468</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>30274</BOYAmt>
        <EOYAmt>33691</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>5207819</BOYAmt>
        <EOYAmt>5587507</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>3098374</BOYAmt>
        <EOYAmt>1711645</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>3098374</BOYAmt>
        <EOYAmt>1711645</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>8306193</BOYAmt>
        <EOYAmt>7299152</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1229484</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-164109</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>6864</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc6">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>9224724</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9009647</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8803387</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9112559</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>9433311</CurrentTaxYearAmt>
        <TotalAmt>45583628</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>9224724</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9009647</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8803387</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9112559</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>9433311</CurrentTaxYearAmt>
        <TotalAmt>45583628</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>45583628</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>77158</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>58548</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>57943</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>91788</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>89193</CurrentTaxYearAmt>
        <TotalAmt>374630</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>77158</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>58548</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>57943</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>91788</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>89193</CurrentTaxYearAmt>
        <TotalAmt>374630</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>9301882</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9068195</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8861330</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9204347</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>9522504</CurrentTaxYearAmt>
        <TotalAmt>45958258</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99180</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99210</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc2">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>760120</OtherCostOrOtherBasisAmt>
        <BookValueAmt>760120</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>7021453</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>6257433</DepreciationAmt>
        <BookValueAmt>764020</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1686929</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1483611</DepreciationAmt>
        <BookValueAmt>203318</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>1727458</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>DEPOSITS AND OTHER</Desc>
        <BookValueAmt>423734</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>423734</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER LIABILITIES</Desc>
        <Amt>33691</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>33691</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>9590555</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>9590555</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>9590555</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>10813175</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>10813175</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>6864</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>6864</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>10820039</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XII, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>BOOK / TAX DEPRECIATION DIFFERENCE 6,864</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc3">
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUZANNE M LEHMAN</PersonNm>
        <TitleTxt>PRESDIENT-MGMT CORP</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>364900</CompensationBasedOnRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>15000</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>22710</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>402610</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>J MICHAEL HAEMMERLE</PersonNm>
        <TitleTxt>TREASURER/SECRETARY</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>266423</CompensationBasedOnRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>4587</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>22710</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>293720</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARIAMMA VARKEY</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>185550</CompensationBasedOnRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>185550</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DINAH BEERCK</PersonNm>
        <TitleTxt>REGIONA; QA NURSE</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>171733</CompensationBasedOnRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>6486</DeferredCompRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>178219</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATT LEHMAN</PersonNm>
        <TitleTxt>VP OF OPS</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>156210</CompensationBasedOnRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>6000</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>12973</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>175183</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBERT MAYO</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>140507</CompensationBasedOnRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>4157</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>9811</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>154475</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOHN WESLEY RAMSEY</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>128868</CompensationBasedOnRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>4459</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>20704</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>154031</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>NONQUALIFIED DEFERRED COMPENSATION FOR SUZANNE M LEHMAN IS INCLUDED ON SCHEDULE J, PART II, COLUMN C.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc4">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>MARK T HAEMMERLE J MICHAEL HAEMMERLE UNCLE/NEPHEW J MICHAEL HAEMMERLE JOHN M HAEMMERLE SON/FATHER MARK T HAEMMERLE JOHN M HAEMMERLE BROTHERS THOMAS J LEHMAN SUZANNE M LEHMAN HUSBAND/WIFE JEFFREY D HAEMMERLE JOHN M HAEMMERLE SON/FATHER</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>AHF CENTRAL STATES DELEGATES OVERALL MANAGEMENT DUTIES TO AHF MANAGEMENT CORP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>PRSIDENT WILL REVIEW FORM 990, ONCE APPROVED, WILL BE MADE AVAILABLE TO THE GOVERNING BODY PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE AND SIGN CONFLICT OF INTEREST DISCLOSURE FORM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR MART T HAEMMERLE, J. MICHAEL HAEMMERLE, SUSAN M LEHMAN, AND MATT LEHMAN ARE IN PART BASED ON A SURVEY BY AN INDEPENDENT FIRM LAST PREPARED IN DECEMBER 2019.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR OTHER OFFICERS OR KEY EMPLOYEES ARE FAIR MARKET VALUE ARE BASED IN PART OF KNOWLEDGE OF THE INDUSTRY AND A HIRED OUTSIDE CONSULTANT FOR KEY EMPLOYEES WAGES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>BOOK / TAX DEPRECIATION DIFFERENCE 6,864</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc5">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AHFHOME OFFICEINC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5920 VENTURE DRIVE STE 200</AddressLine1Txt>
          <CityNm>DUBLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43017</ZIPCd>
        </USAddress>
        <EIN>311275734</EIN>
        <PrimaryActivitiesTxt>ADMIN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AHF SERVICE CORP INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5920 VENTURE DRIVE STE 200</AddressLine1Txt>
          <CityNm>DUBLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43017</ZIPCd>
        </USAddress>
        <EIN>311364129</EIN>
        <PrimaryActivitiesTxt>ADMIN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AHFKENTUCKY-IOWA</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5920 VENTURE DRIVE STE 200</AddressLine1Txt>
          <CityNm>DUBLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43017</ZIPCd>
        </USAddress>
        <EIN>311280637</EIN>
        <PrimaryActivitiesTxt>NURS HOMES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AHF MANAGMENT CORP</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5920 VENTURE DRIVE STE 200</AddressLine1Txt>
          <CityNm>DUBLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43017</ZIPCd>
        </USAddress>
        <EIN>311424220</EIN>
        <PrimaryActivitiesTxt>ADMIN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AHFMONTGOMERY INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5920 VENTURE DRIVE STE 200</AddressLine1Txt>
          <CityNm>DUBLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43017</ZIPCd>
        </USAddress>
        <EIN>311302444</EIN>
        <PrimaryActivitiesTxt>NURS HOME</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AHF OHIO INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5920 VENTURE DRIVE STE 200</AddressLine1Txt>
          <CityNm>DUBLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43017</ZIPCd>
        </USAddress>
        <EIN>463236054</EIN>
        <PrimaryActivitiesTxt>NURS HOME</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AMERICAN HEALTH FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5920 VENTURE DRIVE STE 200</AddressLine1Txt>
          <CityNm>DUBLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43017</ZIPCd>
        </USAddress>
        <EIN>311237141</EIN>
        <PrimaryActivitiesTxt>ADMIN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AHF MANAGEMENT CORP</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>444226</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>