﻿<?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>2026-07-01T15:44:52-04:00</ReturnTs>
    <TaxPeriodEndDt>2025-09-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>383146599</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>COLE NEWTON &amp; DURAN CPAS</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>33762 SCHOOLCRAFT RD</AddressLine1Txt>
        <CityNm>LIVONIA</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48150</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-10-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>382367558</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>HEALTH EMERGENCY MEDICAL</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>SERVICES INC</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>HEAL</BusinessNameControlTxt>
      <PhoneNum>7347277280</PhoneNum>
      <USAddress>
        <AddressLine1Txt>33030 VAN BORN ROAD</AddressLine1Txt>
        <CityNm>WAYNE</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48184</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>ROBERT MILJAN JR</PersonNm>
      <PersonTitleTxt>EXECUTIVE DIRECTOR</PersonTitleTxt>
      <SignatureDt>2026-07-01</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>GRETCHEN I STUART CPA</PreparerPersonNm>
      <PTIN>P01345047</PTIN>
      <PhoneNum>7344272030</PhoneNum>
      <PreparationDt>2026-07-01</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc6">
      <PrincipalOfficerNm>ROBERT MILJAN JR</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>33030 VAN BORN ROAD</AddressLine1Txt>
        <CityNm>WAYNE</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48184</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>2465630</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.HEMS.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1980</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>AMBULANCE AND EMERGENCY HOSPITAL SUPPORT</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>29</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>26</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>12</TotalEmployeeCnt>
      <TotalVolunteersCnt>100</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>1647782</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1535824</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>789823</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>726467</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>10405</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>38597</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>8720</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>3955</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>2456730</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>2304843</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>1599754</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1538920</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>1066172</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>920477</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>2665926</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>2459397</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-209196</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-154554</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>2076422</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>1463187</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>538963</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>87150</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>1537459</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>1376037</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>AMBULANCE AND EMERGENCY HOSPITAL SUPPORT</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>567289</ExpenseAmt>
      <RevenueAmt>726467</RevenueAmt>
      <Desc>PROVIDE TECHNICAL AND ADMINISTRATIVE SUPPORT TO HOSPITALS AND E.M.S. TEAMS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>1572882</ExpenseAmt>
        <Desc>ADMINISTER FEDERALLY FUNDED REGIONAL BIOTERRORISM PLANNING AND COORDINATION.</Desc>
      </ProgSrvcAccomActy2Grp>
      <TotalProgramServiceExpensesAmt>2140171</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc7">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc3">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc3">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc3">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc3">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc3">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc3">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc3">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc3">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc3">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc3">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc3">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc3">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc3">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentId="RetDoc4">false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="RetDoc4">true</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentId="RetDoc4">false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc5">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>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>14</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>12</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>29</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>26</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</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>false</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>ROBERT MILJAN JR</PersonNm>
        <PhoneNum>7347277280</PhoneNum>
        <USAddress>
          <AddressLine1Txt>33030 VAN BORN ROAD</AddressLine1Txt>
          <CityNm>WAYNE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48184</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT MILJAN JR</PersonNm>
        <TitleTxt>EXECUTIVE DI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>146713</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38011</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHAS ARNOLD</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIM MEEKER</PersonNm>
        <TitleTxt>PRESIDENT EL</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER CARPENTER</PersonNm>
        <TitleTxt>PAST PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEFANIE WISE</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>60000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATRICK MILOSTAN</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HOWARD KLAUSNER MD</PersonNm>
        <TitleTxt>MEDICAL DIR</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>25624</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HANNAH EVANS MD</PersonNm>
        <TitleTxt>ALT MEDICAL</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>28000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARC ENGELBRECHT DO</PersonNm>
        <TitleTxt>ALT MEDICAL</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANTHONY CHILDS</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEITH ANALGADEN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MAUREEN BIDDINGER-GRISIUS</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DORETHA BREKKE GRAHAM</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EDITH ENGLISH</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SATHEESH GUNAGA</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NATHANIEL HUNT</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JUDITH KETTENSTOCK</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LEVI LAUNDER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIANNA OSORIO</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SELVAN MURUGAN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AVANI SHETH</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANFORD VIEDER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NINA MORAN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROB SAAD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AARON CARIGNAN</PersonNm>
        <TitleTxt>AUXILIARY ME</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFF DROUILLARD</PersonNm>
        <TitleTxt>AUXILIARY ME</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DUSTIN HAWLEY</PersonNm>
        <TitleTxt>AUXILIARY ME</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KOLBY MILLER</PersonNm>
        <TitleTxt>AUXILIARY ME</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRENT SIEGEL</PersonNm>
        <TitleTxt>AUXILIARY ME</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FRANK GILBERT</PersonNm>
        <TitleTxt>AUXILIATY ME</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>260337</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>38011</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <GovernmentGrantsAmt>1535824</GovernmentGrantsAmt>
      <TotalContributionsAmt>1535824</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEMBER ASSESSMENTS</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>700000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>700000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>AUXILIARY MEMBER ASSESSMENTS</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>18561</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>18561</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>FERMI SERVICE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>6000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PHARMACY</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>1760</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1760</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>WAYNE COUNTY PARTICIPATION</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>146</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>146</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>726467</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>24197</TotalRevenueColumnAmt>
        <ExclusionAmt>24197</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>154400</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>140000</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>14400</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>14400</TotalRevenueColumnAmt>
        <ExclusionAmt>14400</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>24742</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>20787</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>3955</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>2304843</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>726467</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>38597</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>316520</TotalAmt>
        <ProgramServicesAmt>113624</ProgramServicesAmt>
        <ManagementAndGeneralAmt>202896</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>1038776</TotalAmt>
        <ProgramServicesAmt>922521</ProgramServicesAmt>
        <ManagementAndGeneralAmt>116255</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>183624</TotalAmt>
        <ProgramServicesAmt>183624</ProgramServicesAmt>
      </OtherEmployeeBenefitsGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>9905</TotalAmt>
        <ProgramServicesAmt>9905</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>40830</TotalAmt>
        <ProgramServicesAmt>40830</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>20075</TotalAmt>
        <ProgramServicesAmt>20000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>75</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>202991</TotalAmt>
        <ProgramServicesAmt>202991</ProgramServicesAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>16360</TotalAmt>
        <ProgramServicesAmt>16360</ProgramServicesAmt>
      </InformationTechnologyGrp>
      <TravelGrp>
        <TotalAmt>46623</TotalAmt>
        <ProgramServicesAmt>46623</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>2507</TotalAmt>
        <ProgramServicesAmt>2507</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>129704</TotalAmt>
        <ProgramServicesAmt>129704</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>57495</TotalAmt>
        <ProgramServicesAmt>57495</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>HOSPITAL PREPAREDNESS</Desc>
        <TotalAmt>338580</TotalAmt>
        <ProgramServicesAmt>338580</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MAINTENANCE</Desc>
        <TotalAmt>32879</TotalAmt>
        <ProgramServicesAmt>32879</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>12775</TotalAmt>
        <ProgramServicesAmt>12775</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACEUTICALS</Desc>
        <TotalAmt>7326</TotalAmt>
        <ProgramServicesAmt>7326</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>2427</TotalAmt>
        <ProgramServicesAmt>2427</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>2459397</TotalAmt>
        <ProgramServicesAmt>2140171</ProgramServicesAmt>
        <ManagementAndGeneralAmt>319226</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>533492</BOYAmt>
        <EOYAmt>64635</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>429958</BOYAmt>
        <EOYAmt>493419</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>259338</BOYAmt>
        <EOYAmt>241744</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>95559</BOYAmt>
        <EOYAmt>36267</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>6346213</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>5727013</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>740072</BOYAmt>
        <EOYAmt>619200</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>18003</BOYAmt>
        <EOYAmt>7922</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>2076422</BOYAmt>
        <EOYAmt>1463187</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>69243</BOYAmt>
        <EOYAmt>79228</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>451717</BOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>18003</BOYAmt>
        <EOYAmt>7922</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>538963</BOYAmt>
        <EOYAmt>87150</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>1537459</BOYAmt>
        <EOYAmt>1376037</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>1537459</BOYAmt>
        <EOYAmt>1376037</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>2076422</BOYAmt>
        <EOYAmt>1463187</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-154554</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-6868</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc7">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>5098388</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1965938</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1823103</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1647782</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1535824</CurrentTaxYearAmt>
        <TotalAmt>12071035</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>674263</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>691574</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>756513</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>819672</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>751209</CurrentTaxYearAmt>
        <TotalAmt>3693231</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <CurrentTaxYearMinus3YearsAmt>21916</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>20310</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>42226</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>5772651</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2679428</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2599926</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2467454</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2287033</CurrentTaxYearAmt>
        <TotalAmt>15806492</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>15806492</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>24098</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3270</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4308</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10405</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24197</CurrentTaxYearAmt>
        <TotalAmt>66278</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>24098</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3270</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4308</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10405</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24197</CurrentTaxYearAmt>
        <TotalAmt>66278</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <CurrentTaxYearMinus3YearsAmt>9067</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>11048</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>20115</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>5796749</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2691765</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2615282</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2477859</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2311230</CurrentTaxYearAmt>
        <TotalAmt>15892885</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99460</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99460</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <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="RetDoc3">
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>6346213</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>5727013</DepreciationAmt>
        <BookValueAmt>619200</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>619200</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>OPERATING LEASE LIABILITIES</Desc>
        <Amt>7922</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>7922</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>2318762</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-6868</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>20787</OtherRevenueAmt>
      <RevenueNotReportedAmt>13919</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>2304843</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>2304843</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>2480184</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>20787</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>20787</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>2459397</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>2459397</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE. HOWEVER, INCOME FROM ACTIVITIES NOT DIRECTLY RELATED TO THE ORGANIZATIONS TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE ORGANIZATION HAD NO UNRELATED BUSINESS INCOME FOR THE YEAR ENDED SEPTEMBER 30, 2025. THE INTERNAL REVENUE SERVICE HAS CLASSIFIED THE ORGANIZATION AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE 2022 FISCAL FILING YEAR AND PRIOR YEARS, GENERALLY THREE YEARS AFTER THEY WERE FILED. MANAGEMENT HAS EVALUATED FASB ASC 740, INCOME TAXES, AND HAS CONCLUDED IT HAS NO UNCERTAIN TAX POSITIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>SPECIAL EVENT EXPENSES 20,787</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XII, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>SPECIAL EVENT EXPENSES 20,787</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc4">
      <FundraisingEventInformationGrp>
        <Event1Nm>GOLF OUTING</Event1Nm>
        <GrossReceiptsEvent1Amt>24742</GrossReceiptsEvent1Amt>
        <GrossRevenueEvent1Amt>24742</GrossRevenueEvent1Amt>
        <OtherDirectExpensesEvent1Amt>20787</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>24742</GrossReceiptsTotalAmt>
        <GrossRevenueTotalEventsAmt>24742</GrossRevenueTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>20787</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>20787</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>3955</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="RetDoc5">
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <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>ROBERT MILJAN JR</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>130811</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>12000</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3902</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>5460</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>32551</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>184724</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc6">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH MEMBER-HOSPITAL ELECTS A QUALIFIED INDIVIDUAL TO REPRESENT THAT HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990 IS REVIEWED BY THE EXECUTIVE COMMITTEE MEMBERS OF THE BOARD BEFORE IT IS FILED. A COPY IS ALSO PROVIDED TO THE ENTIRE BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>AT EACH BOARD MEETING, EACH PERSON PRESENT IS REQUIRED TO ATTEST TO CONFLICTS OF INTEREST, IF ANY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDES COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC WHEN REQUESTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>SPECIAL EVENT EXPENSES 20,787 SPECIAL EVENT EXPENSES -20,787</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>