﻿<?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>2026-08-11T08:27:09-04:00</ReturnTs>
    <TaxPeriodEndDt>2025-09-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>561056216</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>MCCANNON ROGERS DRISCOLL &amp; ASSOC LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>PO BOX 339</AddressLine1Txt>
        <CityNm>GASTONIA</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>280530339</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-10-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>581958398</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>GASTON FAMILY HEALTH SERVICES INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>GAST</BusinessNameControlTxt>
      <PhoneNum>7048743313</PhoneNum>
      <USAddress>
        <AddressLine1Txt>200 E SECOND AVENUE</AddressLine1Txt>
        <CityNm>GASTONIA</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>28052</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>JARRETT MORRIS</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>7048741905</PhoneNum>
      <SignatureDt>2026-02-15</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>false</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>BENJAMIN P ALBRIGHT III</PreparerPersonNm>
      <PTIN>P02010022</PTIN>
      <PhoneNum>7048670264</PhoneNum>
      <PreparationDt>2026-08-11</PreparationDt>
      <SelfEmployedInd>X</SelfEmployedInd>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc5">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>KINTEGRA HEALTH</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>ROBERT SPENCER</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>200 E SECOND AVENUE</AddressLine1Txt>
        <CityNm>GASTONIA</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>28052</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>162631416</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.KINTEGRA.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1991</FormationYr>
      <LegalDomicileStateCd>NC</LegalDomicileStateCd>
      <ActivityOrMissionDesc>GASTON FAMILY HEALTH SERVICES IS A COMMUNITY-SPONSORED, FAMILY-CENTERED PROVIDER OF HEALTH CARE, EDUCATION, AND PREVENTIVE CARE WITHOUT REGARD TO THE ABILITY TO PAY.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>22</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>22</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>1484</TotalEmployeeCnt>
      <TotalVolunteersCnt>42</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>16249319</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>17474241</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>116914413</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>140706263</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>336406</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>1035477</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>1578160</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>3151737</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>135078298</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>162367718</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>65881337</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>78114799</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>62858009</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>64548137</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>128739346</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>142662936</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>6338952</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>19704782</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>78844372</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>103463954</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>29490219</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>34590385</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>49354153</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>68873569</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>GASTON FAMILY HEALTH SERVICES IS A COMMUNITY-SPONSORED, FAMILY-CENTERED PROVIDER OF HEALTH CARE, EDUCATION, AND PREVENTIVE CARE WITHOUT REGARD TO THE ABILITY TO PAY.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>120092336</ExpenseAmt>
      <RevenueAmt>140706263</RevenueAmt>
      <Desc>PROVIDED PRIMARY MEDICAL CARE, DENTAL, AND BEHAVIORAL CARE FOR THE UNINSURED AND UNDERINSURED.</Desc>
      <TotalProgramServiceExpensesAmt>120092336</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc6">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">true</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>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc4">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>56</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>1484</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>false</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>22</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>22</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>JARRETT MORRIS</PersonNm>
        <PhoneNum>7048743313</PhoneNum>
        <USAddress>
          <AddressLine1Txt>200 E SECOND AVENUE</AddressLine1Txt>
          <CityNm>GASTONIA</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>28052</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT SPENCER</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>799938</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>61000</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SURENDRA SINGH SIDHU</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>306337</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>37875</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EUGENE REYNOLDS</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>298158</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30266</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHIRLEY OCLOO</PersonNm>
        <TitleTxt>MEDICAL DIRE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>283470</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44372</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHANA JAMES-NZAMBELE</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>250726</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21180</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AREGAI GIRMAY</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>223764</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>39291</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHLEEN HARKNETT</PersonNm>
        <TitleTxt>ASSISTANT ME</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>218185</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35985</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>REVONDA JESSUP</PersonNm>
        <TitleTxt>PODIATRIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>222235</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26756</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VERONICA FEDUNIEC</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>219449</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22071</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>REVA HOLLAND</PersonNm>
        <TitleTxt>VP MED. OPER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>197064</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27397</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TAMEKO SOWELL</PersonNm>
        <TitleTxt>CHIEF DENTAL</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>188474</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17107</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIN LIND MYER</PersonNm>
        <TitleTxt>BEHAV HEALTH</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>169214</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31975</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JESSICA JACKSON</PersonNm>
        <TitleTxt>ASSISTANT DE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>173625</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21431</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SENANU K OCLOO</PersonNm>
        <TitleTxt>CIO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>162711</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26560</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAVONDIA ALEXANDER</PersonNm>
        <TitleTxt>CQO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>166607</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20944</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JARRETT MORRIS</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>161611</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16308</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER BENNETT</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RALPH BENTLEY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAULA BLACK</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURA CLARK</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LOUISE GRIGG</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN HERRERA</PersonNm>
        <TitleTxt>VICE CHAIRMA</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PHIL HINELY</PersonNm>
        <TitleTxt>CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHELE KNAPP</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES MACOMSON</PersonNm>
        <TitleTxt>BOARD DIRECT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THERESA MATTHEWS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER MCCRACKEN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN MCGINNIS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KRISTIN MONZA</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHUCK MOORE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RAMONA NEAL</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHANIE PARENT</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT SCARBOROUGH</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHIRLEY STOWE</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>REID THORNBURG</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR NICOLE WATERS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS WILLIAMS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BETTY WORTHY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4041568</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>480518</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>32</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <GovernmentGrantsAmt>13528001</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>3946240</AllOtherContributionsAmt>
      <TotalContributionsAmt>17474241</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>FAMILY HEALTH CLINIC</Desc>
        <TotalRevenueColumnAmt>140706263</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>140706263</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>140706263</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>660696</TotalRevenueColumnAmt>
        <ExclusionAmt>660696</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>638479</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>263698</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>374781</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>374781</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>374781</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER INCOME</Desc>
        <TotalRevenueColumnAmt>3151737</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3151737</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>3151737</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>162367718</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>144232781</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>660696</ExclusionAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>59737287</TotalAmt>
        <ProgramServicesAmt>47789830</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11947457</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>13660880</TotalAmt>
        <ProgramServicesAmt>10928704</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2732176</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>4716632</TotalAmt>
        <ProgramServicesAmt>3773306</ProgramServicesAmt>
        <ManagementAndGeneralAmt>943326</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>245621</TotalAmt>
        <ManagementAndGeneralAmt>245621</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>658928</TotalAmt>
        <ManagementAndGeneralAmt>658928</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>117329</TotalAmt>
        <ManagementAndGeneralAmt>117329</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1192735</TotalAmt>
        <ProgramServicesAmt>954188</ProgramServicesAmt>
        <ManagementAndGeneralAmt>238547</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>3108967</TotalAmt>
        <ProgramServicesAmt>2997683</ProgramServicesAmt>
        <ManagementAndGeneralAmt>111284</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>514153</TotalAmt>
        <ManagementAndGeneralAmt>514153</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>25885</TotalAmt>
        <ManagementAndGeneralAmt>25885</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>2713248</TotalAmt>
        <ProgramServicesAmt>1996247</ProgramServicesAmt>
        <ManagementAndGeneralAmt>717001</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>390830</TotalAmt>
        <ProgramServicesAmt>312664</ProgramServicesAmt>
        <ManagementAndGeneralAmt>78166</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACEUTICAL SUPPLIES</Desc>
        <TotalAmt>24719523</TotalAmt>
        <ProgramServicesAmt>24719523</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CONTRACTED SERVICES</Desc>
        <TotalAmt>19474104</TotalAmt>
        <ProgramServicesAmt>15579283</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3894821</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SYSTEM UPGRADES</Desc>
        <TotalAmt>2908801</TotalAmt>
        <ProgramServicesAmt>2908801</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TELEPHONE</Desc>
        <TotalAmt>1729532</TotalAmt>
        <ProgramServicesAmt>1383626</ProgramServicesAmt>
        <ManagementAndGeneralAmt>345906</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>6748481</TotalAmt>
        <ProgramServicesAmt>6748481</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>142662936</TotalAmt>
        <ProgramServicesAmt>120092336</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22570600</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>18383352</BOYAmt>
        <EOYAmt>34736793</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>4146219</BOYAmt>
        <EOYAmt>2589812</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>5709491</BOYAmt>
        <EOYAmt>9724326</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1109690</BOYAmt>
        <EOYAmt>1388099</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>629454</BOYAmt>
        <EOYAmt>589230</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>45467244</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>13600035</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>26016656</BOYAmt>
        <EOYAmt>31867209</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>4303750</BOYAmt>
        <EOYAmt>4303750</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>18545760</BOYAmt>
        <EOYAmt>18264735</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>78844372</BOYAmt>
        <EOYAmt>103463954</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>14029059</BOYAmt>
        <EOYAmt>16970749</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>960030</BOYAmt>
        <EOYAmt>870032</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>14501130</BOYAmt>
        <EOYAmt>16749604</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>29490219</BOYAmt>
        <EOYAmt>34590385</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>48794590</BOYAmt>
        <EOYAmt>67755903</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>559563</BOYAmt>
        <EOYAmt>1117666</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>49354153</BOYAmt>
        <EOYAmt>68873569</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>78844372</BOYAmt>
        <EOYAmt>103463954</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>19704782</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>-185366</OtherChangesInNetAssetsAmt>
      <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="RetDoc6">
      <HospitalInd>X</HospitalInd>
    </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">
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>25244516</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3667765</DepreciationAmt>
        <BookValueAmt>21576751</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>11775447</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>7206789</DepreciationAmt>
        <BookValueAmt>4568658</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>8447281</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2725481</DepreciationAmt>
        <BookValueAmt>5721800</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>31867209</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>LEASE RIGHT OF USE</Desc>
        <BookValueAmt>14402827</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OTHER RECEIVABLES</Desc>
        <BookValueAmt>2581898</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>CASH SURRENDER - LIFE INSURANCE</Desc>
        <BookValueAmt>945967</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>BENEFICIAL INTEREST HELD BY OTHERS</Desc>
        <BookValueAmt>202242</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>SECURITY DEPOSIT</Desc>
        <BookValueAmt>131801</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>18264735</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>OPERATING LEASE</Desc>
        <Amt>14898909</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>RESERVE ON THIRD-PARTY PAYER SETTLEM</Desc>
        <Amt>1850695</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>16749604</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>164048854</TotalRevEtcAuditedFinclStmtAmt>
      <DonatedServicesAndUseFcltsAmt>93000</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>1588136</OtherRevenueAmt>
      <RevenueNotReportedAmt>1681136</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>162367718</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>162367718</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>144529438</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>93000</DonatedServicesUseFcltsAmt>
      <OtherExpensesIncludedAmt>1773502</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>1866502</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>142662936</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>142662936</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2025 AND 2024. THE ORGANIZATION HAS TAX YEARS ENDING SEPTEMBER 30, 2024, 2023, AND 2022 SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>DONATED INVENTORY 1,468,883 HIGHLAND GROCERY EXPENSES 119,253</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XII, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>DONATED INVENTORY 1,468,883 NON-CASH LEASE 185,366 HIGHLAND GROCERY EXPENSES 119,253</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc4">
      <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 SPENCER</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>405312</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>394626</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>61000</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>860938</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SURENDRA SINGH SIDHU</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <BaseCompensationFilingOrgAmt>300000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>6337</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>21115</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16760</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>344212</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EUGENE REYNOLDS</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <BaseCompensationFilingOrgAmt>260171</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>37987</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>23471</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>6795</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>328424</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHIRLEY OCLOO</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>264837</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>18633</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>27612</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16760</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>327842</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHANA JAMES-NZAMBELE</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <BaseCompensationFilingOrgAmt>246807</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>3919</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>21180</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>271906</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AREGAI GIRMAY</PersonNm>
        <TitleTxt>PROVIDER</TitleTxt>
        <BaseCompensationFilingOrgAmt>223764</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>22531</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16760</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>263055</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATHLEEN HARKNETT</PersonNm>
        <TitleTxt>ASSISTANT MED DIRECT</TitleTxt>
        <BaseCompensationFilingOrgAmt>218185</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19225</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16760</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>254170</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>REVONDA JESSUP</PersonNm>
        <TitleTxt>PODIATRIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>222235</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>21011</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>5745</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>248991</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>VERONICA FEDUNIEC</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>219449</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>22071</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>241520</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>REVA HOLLAND</PersonNm>
        <TitleTxt>VP MED. OPERATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>180535</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>16529</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7997</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>19400</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>224461</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TAMEKO SOWELL</PersonNm>
        <TitleTxt>CHIEF DENTAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>188474</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>17107</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>205581</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERIN LIND MYER</PersonNm>
        <TitleTxt>BEHAV HEALTH OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>162377</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>6837</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15215</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16760</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>201189</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JESSICA JACKSON</PersonNm>
        <TitleTxt>ASSISTANT DENTAL DIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>173625</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>14636</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>6795</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>195056</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SENANU K OCLOO</PersonNm>
        <TitleTxt>CIO</TitleTxt>
        <BaseCompensationFilingOrgAmt>156437</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>6274</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>13959</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12601</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>189271</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LAVONDIA ALEXANDER</PersonNm>
        <TitleTxt>CQO</TitleTxt>
        <BaseCompensationFilingOrgAmt>166607</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>14149</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>6795</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>187551</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JARRETT MORRIS</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>161611</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>16308</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>177919</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS PRESENTED FIRST TO THE FINANCE COMMITTEE AND THEN PRESENTED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REQUIRES BOARD MEMBERS AND STAFF TO ANNUALLY SIGN CONFLICT OF INTEREST STATEMENTS. EMPLOYEES ARE ADVISED OF CONFLICT OF INTEREST POLICIES UPON HIRING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE IS A PERSONNEL COMMITTEE THAT REVIEWS INTERNAL DOCUMENT AND NATIONAL SURVEY DATA AND MAKES RECOMMENDATION TO THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE DIRECTOR IS RESPONSIBLE FOR SETTING SALARIES FOR ALL OTHER EMPLOYEES. A PERFORMANCE REVIEW IS CONDUCTED ANNUALLY, AND BASED UPON THIS PLUS CONSIDERATION OF MARKET AND INDUSTRY COMPENSATION FOR LIKE POSITIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>DONATED INVENTORY 1,468,883 HIGHLAND GROCERY EXPENSES 119,253 DONATED INVENTORY -1,468,883 NON-CASH LEASE -185,366 HIGHLAND GROCERY EXPENSES -119,253 TOTAL -185,366</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>