﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2024v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-03-26T10:59:44-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>471019942</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CREATIVE PLANNING TAX LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>100 E PARK AVE STE 300</AddressLine1Txt>
        <CityNm>WATERLOO</CityNm>
        <StateAbbreviationCd>IA</StateAbbreviationCd>
        <ZIPCd>50703</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>421056708</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>ST FRANCIS MANOR</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>STFR</BusinessNameControlTxt>
      <PhoneNum>6412367592</PhoneNum>
      <USAddress>
        <AddressLine1Txt>2021 4TH AVENUE</AddressLine1Txt>
        <CityNm>GRINNELL</CityNm>
        <StateAbbreviationCd>IA</StateAbbreviationCd>
        <ZIPCd>50112</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>DION SCHRACK</PersonNm>
      <PersonTitleTxt>ADMINISTRATOR</PersonTitleTxt>
      <PhoneNum>6412367592</PhoneNum>
      <SignatureDt>2025-03-25</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>BRIAN ARONSON CPA</PreparerPersonNm>
      <PTIN>P01425251</PTIN>
      <PhoneNum>3192346885</PhoneNum>
      <PreparationDt>2025-03-25</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>DION SCHRACK</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>2021 4TH AVENUE</AddressLine1Txt>
        <CityNm>GRINNELL</CityNm>
        <StateAbbreviationCd>IA</StateAbbreviationCd>
        <ZIPCd>50112</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>11250487</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.STFRANCISMANOR.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1976</FormationYr>
      <LegalDomicileStateCd>IA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>CONTINUING CARE RETIREMENT COMMUNITY</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>10</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>258</TotalEmployeeCnt>
      <TotalVolunteersCnt>13</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>153459</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>136767</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>9750314</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>10104848</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1700748</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>645970</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>294865</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>336532</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>11899386</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>11224117</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>7098520</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>7487264</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>12937</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>3718382</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>4047188</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>10816902</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>11534452</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>1082484</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-310335</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>22930436</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>22540623</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>17922352</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>17842874</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>5008084</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>4697749</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>THE MISSION OF ST. FRANCIS MANOR IS TO CONSISTENTLY PROVIDE QUALITY SERVICE, STRIVING TO ENSURE A SUPPORTIVE ENVIRONMENT THAT PROMOTES THE PHYSICAL, MENTAL, EMOTIONAL AND SPIRITUAL WELL-BEING OF ALL THOSE WE SERVE, THROUGH DIGNITY, RESPECT AND INTEGRITY.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>10141685</ExpenseAmt>
      <RevenueAmt>10441380</RevenueAmt>
      <Desc>OPERATE A CONTINUING CARE RETIREMENT COMMUNITY TO CARE FOR THE ELDERLY. ST. FRANCIS MANOR, INC. IS A SKILLED NURSING FACILITY OFFERING 78 NURSING BEDS WHILE HAMMOND CENTER OPERATES AN ASSISTED LIVING FACILITY WITH 20 APARTMENTS.</Desc>
      <TotalProgramServiceExpensesAmt>10141685</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="RetDoc1053100001">1</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>0</InvestTaxExemptBondsInd>
      <EscrowAccountInd>0</EscrowAccountInd>
      <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">0</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">1</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">1</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">0</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>24</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>258</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>10</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>DION SCHRACK</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>6412367592</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2021 4TH AVE</AddressLine1Txt>
          <CityNm>GRINNELL</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>50112</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <InfoInScheduleOPartVIIInd>X</InfoInScheduleOPartVIIInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>SAMMI BRYAN</PersonNm>
        <TitleTxt>DIRECTOR, HAMMOND CENTER MGR.</TitleTxt>
        <AverageHoursPerWeekRt>41.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>118837</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10253</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERYL VER PLOEG</PersonNm>
        <TitleTxt>CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LEE MCFEE</PersonNm>
        <TitleTxt>VICE-CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FRAN CONN END SEPT 2024</PersonNm>
        <TitleTxt>VICE-CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KENT BROWN</PersonNm>
        <TitleTxt>SECRETARY/TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CONNIE SCURR</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINDSEY WARNICK</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MIKE THORNDIKE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TODD HONOLD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LANCE HORBACH BEG OCT 2024</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY DOWNEY BEG OCT 2024</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY SHEBECK END SEPT 2024</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DION SCHRACK</PersonNm>
        <TitleTxt>ADMINISTRATOR</TitleTxt>
        <AverageHoursPerWeekRt>55.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>200779</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26343</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KORY PROBASCO</PersonNm>
        <TitleTxt>DIRECTOR OF NURSING</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>139967</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21029</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROSALIND VANGORP</PersonNm>
        <TitleTxt>NURSE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>128075</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9375</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAYLA LINT</PersonNm>
        <TitleTxt>ASST. DIRECTOR OF NURS</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>113717</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3513</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROY MARSHALL</PersonNm>
        <TitleTxt>NURSE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>124929</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3513</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MORGAN FRAKER</PersonNm>
        <TitleTxt>HUMAN RESOURCES SPECIALIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>104460</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8300</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>930764</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>82326</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>8</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>VANS ROOFING SIDING &amp; CONSTRUCTION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4042 170TH ST</AddressLine1Txt>
            <CityNm>BROOKLYN</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>52211</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ROOF &amp; SIDING REPAIRS</ServicesDesc>
        <CompensationAmt>106724</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>136767</AllOtherContributionsAmt>
      <TotalContributionsAmt>136767</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NURSING CARE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>8768751</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8768751</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>DEFERRED REVENUE RECOGNIZED</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>797844</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>797844</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER OPERATING SERVICES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>271559</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>271559</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ANCILLARY SERVICES</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>266694</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>266694</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>10104848</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>54247</TotalRevenueColumnAmt>
        <ExclusionAmt>54247</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>618093</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>26370</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>591723</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>591723</TotalRevenueColumnAmt>
        <ExclusionAmt>591723</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>CONTRACT REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>336532</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>336532</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>336532</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>11224117</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10441380</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>645970</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>356212</TotalAmt>
        <ProgramServicesAmt>129090</ProgramServicesAmt>
        <ManagementAndGeneralAmt>226032</ManagementAndGeneralAmt>
        <FundraisingAmt>1090</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6331895</TotalAmt>
        <ProgramServicesAmt>5860647</ProgramServicesAmt>
        <ManagementAndGeneralAmt>466153</ManagementAndGeneralAmt>
        <FundraisingAmt>5095</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>283882</TotalAmt>
        <ProgramServicesAmt>278677</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5133</ManagementAndGeneralAmt>
        <FundraisingAmt>72</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>515275</TotalAmt>
        <ProgramServicesAmt>459293</ProgramServicesAmt>
        <ManagementAndGeneralAmt>55518</ManagementAndGeneralAmt>
        <FundraisingAmt>464</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>9076</TotalAmt>
        <ManagementAndGeneralAmt>9076</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>135246</TotalAmt>
        <ManagementAndGeneralAmt>135246</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>28336</TotalAmt>
        <ProgramServicesAmt>19347</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3209</ManagementAndGeneralAmt>
        <FundraisingAmt>5780</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>9790</TotalAmt>
        <ManagementAndGeneralAmt>9790</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>98115</TotalAmt>
        <ManagementAndGeneralAmt>98115</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>433625</TotalAmt>
        <ProgramServicesAmt>206549</ProgramServicesAmt>
        <ManagementAndGeneralAmt>227076</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <InterestGrp>
        <TotalAmt>133309</TotalAmt>
        <ProgramServicesAmt>133309</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1381605</TotalAmt>
        <ProgramServicesAmt>1381605</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>54466</TotalAmt>
        <ManagementAndGeneralAmt>54466</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>958295</TotalAmt>
        <ProgramServicesAmt>958295</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FOOD</Desc>
        <TotalAmt>342052</TotalAmt>
        <ProgramServicesAmt>342052</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>165572</TotalAmt>
        <ProgramServicesAmt>165572</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>160791</TotalAmt>
        <ProgramServicesAmt>160791</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>136910</TotalAmt>
        <ProgramServicesAmt>46458</ProgramServicesAmt>
        <ManagementAndGeneralAmt>90016</ManagementAndGeneralAmt>
        <FundraisingAmt>436</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>11534452</TotalAmt>
        <ProgramServicesAmt>10141685</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1379830</ManagementAndGeneralAmt>
        <FundraisingAmt>12937</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1128219</BOYAmt>
        <EOYAmt>845554</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1376377</BOYAmt>
        <EOYAmt>2105286</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>787567</BOYAmt>
        <EOYAmt>602956</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>83860</BOYAmt>
        <EOYAmt>53215</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>34288</BOYAmt>
        <EOYAmt>34639</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>225876</BOYAmt>
        <EOYAmt>44253</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>38594690</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>19739970</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>19294249</BOYAmt>
        <EOYAmt>18854720</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>22930436</BOYAmt>
        <EOYAmt>22540623</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>745381</BOYAmt>
        <EOYAmt>686623</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>12335854</BOYAmt>
        <EOYAmt>12481498</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>4801117</BOYAmt>
        <EOYAmt>4634753</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>40000</BOYAmt>
        <EOYAmt>40000</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>17922352</BOYAmt>
        <EOYAmt>17842874</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>5008038</BOYAmt>
        <EOYAmt>4697749</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>46</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>5008084</BOYAmt>
        <EOYAmt>4697749</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>22930436</BOYAmt>
        <EOYAmt>22540623</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-310335</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>1013421</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1599496</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>111130</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>153459</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>136767</CurrentTaxYearAmt>
        <TotalAmt>3014273</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>7910100</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7927956</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8967350</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10045179</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10441380</CurrentTaxYearAmt>
        <TotalAmt>45291965</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>8923521</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9527452</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9078480</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10198638</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10578147</CurrentTaxYearAmt>
        <TotalAmt>48306238</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <CurrentTaxYearMinus4YearsAmt>406238</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>380700</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>647097</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>856332</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1106837</CurrentTaxYearAmt>
        <TotalAmt>3397204</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>406238</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>380700</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>647097</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>856332</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1106837</CurrentTaxYearAmt>
        <TotalAmt>3397204</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>44909034</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>3214</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3986</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7135</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>32254</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>54247</CurrentTaxYearAmt>
        <TotalAmt>100836</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>3214</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3986</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7135</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>32254</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>54247</CurrentTaxYearAmt>
        <TotalAmt>100836</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>8926735</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9531438</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9085615</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10230892</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10632394</CurrentTaxYearAmt>
        <TotalAmt>48407074</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.92770</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.94770</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00210</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00110</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>791891</OtherCostOrOtherBasisAmt>
        <BookValueAmt>791891</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>32164952</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>15454835</DepreciationAmt>
        <BookValueAmt>16710117</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>2173465</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1698131</DepreciationAmt>
        <BookValueAmt>475334</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>3464382</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2587004</DepreciationAmt>
        <BookValueAmt>877378</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>18854720</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>RESIDENT DEPOSITS HELD</Desc>
        <Amt>40000</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>40000</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DION SCHRACK</PersonNm>
        <TitleTxt>ADMINISTRATOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>200779</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>26343</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>227122</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KORY PROBASCO</PersonNm>
        <TitleTxt>DIRECTOR OF NURSING</TitleTxt>
        <BaseCompensationFilingOrgAmt>139967</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21029</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>160996</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCE COMMITTEE MET TO CONSIDER THE APPROPRIATE COMPENSATION FOR THE ADMINISTRATOR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CITY OF GRINNELL IOWA</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>426004734</BondIssuerEIN>
        <BondIssuedDt>2010-12-17</BondIssuedDt>
        <IssuePriceAmt>1250000</IssuePriceAmt>
        <PurposeDesc>HEALTH CARE FACILITY REVENUE BOND (ST. FRANCIS MANOR PROJECT) SERIES 2010</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>1</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>1250000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>36962</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>1250000</CapitalExpendituresAmt>
        <SubstantialCompletionYr>2012</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>SHELLEY SCHRACK</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>ADMINISTRATOR'S WIFE</RelationshipDescriptionTxt>
        <TransactionAmt>77093</TransactionAmt>
        <TransactionDesc>PAYROLL &amp; BENEFITS</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>MADISON ELLIS</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>ADMINISTRATOR'S DAUGHTER</RelationshipDescriptionTxt>
        <TransactionAmt>16670</TransactionAmt>
        <TransactionDesc>PAYROLL, NO BENEFITS</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ST. FRANCIS MANOR, INC. FINANCE COMMITTEE REVIEWED THE 990 AND APPROVED THE RETURN BEFORE IT WAS FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>SFM CONDUCTS PERIODIC REVIEWS INCLUDING WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARMS-LENGTH BARGAINING AND WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CHARITABLE PURPOSES OF SFM AND DO NOT RESULT IN INUREMENT OR IMPERMISSABLE PRIVATE BENEFIT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 18</FormAndLineReferenceDesc>
        <ExplanationTxt>ST. FRANCIS MANOR, INC. WILL PROVIDE A COPY OF ITS 990 UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ST. FRANCIS MANOR, INC. WILL PROVIDE A COPY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, SECTION A, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>SAMMI BRYAN WAS COMPENSATED FOR SERVICES AS AN EMPLOYEE AT HAMMOND CENTER, AND NOT AS A MEMBER OF THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMUNITY SERVICES OF ST FRANCIS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2021 4TH STREET</AddressLine1Txt>
          <CityNm>GRINNELL</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>50112</ZIPCd>
        </USAddress>
        <EIN>205825952</EIN>
        <PrimaryActivitiesTxt>TO PROVIDE HOME HEALTH CARE AND HOME REPAIR</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
        <TotalIncomeAmt>133210</TotalIncomeAmt>
        <EndOfYearAssetsAmt>17711</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ST FRANCIS MANOR INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HAMMOND CENTER OF ST FRANCIS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2021 4TH STREET</AddressLine1Txt>
          <CityNm>GRINNELL</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>50112</ZIPCd>
        </USAddress>
        <EIN>812043570</EIN>
        <PrimaryActivitiesTxt>TO PROVIDE ASSISTED LIVING FACILITY FOR THE ELDERLY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
        <TotalIncomeAmt>1561957</TotalIncomeAmt>
        <EndOfYearAssetsAmt>4340448</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ST FRANCIS MANOR INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST FRANCIS MANOR FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2021 FOURTH AVENUE</AddressLine1Txt>
          <CityNm>GRINNELL</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>50112</ZIPCd>
        </USAddress>
        <EIN>262179671</EIN>
        <PrimaryActivitiesTxt>RECEIVE, MAINTAIN &amp; ACCEPT GIFTS FOR THE SOLE PURPOSE OF CONTRIBUTING TO SFM</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>PUBLIC CHARITY</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ST FRANCIS MANOR INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SEELAND PARK</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2021 4TH AVENUE</AddressLine1Txt>
          <CityNm>GRINNELL</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>50112</ZIPCd>
        </USAddress>
        <EIN>421337462</EIN>
        <PrimaryActivitiesTxt>MANAGE, OPERATE AND MAINTAIN THE COMMON PROPERTY OF SEELAND PARK</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ST FRANCIS MANOR INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ST FRANCIS MANOR FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>118457</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH CONTRIBUTION</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SEELAND PARK</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>131400</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>MONTHLY FEE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SEELAND PARK</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>356932</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COSTS PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>