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      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>2586730</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>74261</AllOtherContributionsAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>4110499</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4110499</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>4110499</TotalProgramServiceRevenueAmt>
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        <TotalRevenueColumnAmt>101920</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>101920</RelatedOrExemptFuncIncomeAmt>
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      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>4129452</SecuritiesAmt>
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      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>4236228</SecuritiesAmt>
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      <GainOrLossGrp>
        <SecuritiesAmt>-106776</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-106776</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-106776</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>34349</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>13641</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>20708</TotalRevenueColumnAmt>
        <ExclusionAmt>20708</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1752</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1752</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueTotalAmt>1752</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>6789094</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4107395</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>20708</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
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        <ManagementAndGeneralAmt>596890</ManagementAndGeneralAmt>
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        <TotalAmt>3293569</TotalAmt>
        <ProgramServicesAmt>3016615</ProgramServicesAmt>
        <ManagementAndGeneralAmt>273301</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>11741</ProgramServicesAmt>
        <ManagementAndGeneralAmt>960</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>424728</TotalAmt>
        <ProgramServicesAmt>320044</ProgramServicesAmt>
        <ManagementAndGeneralAmt>104684</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>283069</TotalAmt>
        <ProgramServicesAmt>222935</ProgramServicesAmt>
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        <FundraisingAmt>312</FundraisingAmt>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>1188</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ProgramServicesAmt>41323</ProgramServicesAmt>
        <ManagementAndGeneralAmt>189242</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>30418</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>206174</TotalAmt>
        <ProgramServicesAmt>204662</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1512</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>28490</TotalAmt>
        <ProgramServicesAmt>27150</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1340</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
        <TotalAmt>41754</TotalAmt>
        <ProgramServicesAmt>24828</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16926</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>290956</TotalAmt>
        <ProgramServicesAmt>232067</ProgramServicesAmt>
        <ManagementAndGeneralAmt>58889</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>277833</TotalAmt>
        <ProgramServicesAmt>228952</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48881</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>135703</TotalAmt>
        <ProgramServicesAmt>135264</ProgramServicesAmt>
        <ManagementAndGeneralAmt>439</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>28745</TotalAmt>
        <ProgramServicesAmt>23660</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5085</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>91962</ProgramServicesAmt>
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      </DepreciationDepletionGrp>
      <InsuranceGrp>
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        <ProgramServicesAmt>76455</ProgramServicesAmt>
        <ManagementAndGeneralAmt>712</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
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        <ProgramServicesAmt>224552</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2471</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>MEMBERSHIP DUES</Desc>
        <TotalAmt>23331</TotalAmt>
        <ProgramServicesAmt>17858</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5473</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>COMMUNITY SUPPORT</Desc>
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        <ProgramServicesAmt>11434</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>12269</ProgramServicesAmt>
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      <AllOtherExpensesGrp>
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        <ProgramServicesAmt>18182</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>4941953</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1426456</ManagementAndGeneralAmt>
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        <EOYAmt>1921093</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>596460</EOYAmt>
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      <OthNotesLoansReceivableNetGrp>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>57619</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>3946823</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>2514353</EOYAmt>
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        <EOYAmt>3615574</EOYAmt>
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        <EOYAmt>141513</EOYAmt>
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        <EOYAmt>782485</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>8317199</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>9099684</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
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      <NetUnrlzdGainsLossesInvstAmt>-482718</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-69575</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
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        <CurrentTaxYearMinus3YearsAmt>782826</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>814738</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2022826</CurrentTaxYearMinus1YearAmt>
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        <CurrentTaxYearMinus2YearsAmt>5266278</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3780932</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4110499</CurrentTaxYearAmt>
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      <Total509Grp>
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        <CurrentTaxYearMinus2YearsAmt>6081016</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5803758</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>6771490</CurrentTaxYearAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
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      <SubstantialContributorsAmtGrp>
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      <SubstAndDsqlfyPrsnsTotGrp>
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      <GrossInvestmentIncome509Grp>
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      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearMinus3YearsAmt>53402</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>659</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearAmt>1752</CurrentTaxYearAmt>
        <TotalAmt>112872</TotalAmt>
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        <CurrentTaxYearMinus3YearsAmt>6659658</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6149102</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5907809</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>6875162</CurrentTaxYearAmt>
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      <PublicSupportPY509Pct>0.98370</PublicSupportPY509Pct>
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      <InvestmentIncomePYPct>0.01290</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME - 2018 AMOUNT: $ 57,059. 2019 AMOUNT: $ 53,402. 2020 AMOUNT: $ 659. 2022 AMOUNT: $ 1,752.</ExplanationTxt>
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    <IRS990ScheduleB documentId="RetDoc1234500001">
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        <ContributorBusinessName>
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        <ContributorUSAddress>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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        <InvestmentEarningsOrLossesAmt>-10174</InvestmentEarningsOrLossesAmt>
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        <EndYearBalanceAmt>46249</EndYearBalanceAmt>
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      <CYMinus1YrEndwmtFundGrp>
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        <InvestmentEarningsOrLossesAmt>6999</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>59283</EndYearBalanceAmt>
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      <CYMinus2YrEndwmtFundGrp>
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        <InvestmentEarningsOrLossesAmt>4659</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>2683</GrantsOrScholarshipsAmt>
        <EndYearBalanceAmt>52284</EndYearBalanceAmt>
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      <CYMinus3YrEndwmtFundGrp>
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        <InvestmentEarningsOrLossesAmt>5732</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>15574</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>1014</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>50308</EndYearBalanceAmt>
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      <CYMinus4YrEndwmtFundGrp>
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        <ContributionsAmt>550</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-131</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>6582</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>61164</EndYearBalanceAmt>
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      <EndowmentsHeldUnrelatedOrgInd>1</EndowmentsHeldUnrelatedOrgInd>
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        <BookValueAmt>316803</BookValueAmt>
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      <BuildingsGrp>
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        <BookValueAmt>1953131</BookValueAmt>
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      <LeaseholdImprovementsGrp>
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        <BookValueAmt>18361</BookValueAmt>
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      <EquipmentGrp>
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        <BookValueAmt>47141</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
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      <OtherRevenueAmt>13641</OtherRevenueAmt>
      <RevenueNotReportedAmt>-469077</RevenueNotReportedAmt>
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      <RevenueNotReportedFinclStmtAmt>30418</RevenueNotReportedFinclStmtAmt>
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      <InvestmentExpensesNotIncld2Amt>30418</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>30418</ExpensesNotRptFinclStmtAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART V, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>VISITING NURSE ASSOCIATION (VNA) HAS A BENEFICIAL INTEREST IN THE AGENCY ENDOWMENT FUND HELD BY THE COMMUNITY FOUNDATION OF ST. CLAIR COUNTY (THE "FOUNDATION"). THE AGENCY ENDOWMENT FUND IS INTENDED TO SUPPORT THE PROGRAMS, PROJECTS, AND OPERATIONS OF BLUE WATER HOSPICE (BWH) AND VNA. THE FUND'S NET INCOME PER THE FOUNDATION'S SPENDING POLICY SHALL BE MADE AVAILABLE TO ASSIST BWH AND VNA IN FULFILLMENT OF THEIR MISSION. THE FOUNDATION MAY AWARD UP TO AN ADDITIONAL 10 PERCENT TO SUPPORT SPECIAL PROJECTS OR TO MEET EXTRAORDINARY NEEDS OF BWH AND VNA ANNUALLY.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>SPECIAL EVENT EXPENSES 13,641.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>SPECIAL EVENT EXPENSES 13,641. BAD DEBT EXPENSE 69,575.</ExplanationTxt>
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        <Event1Nm>LIGHT UP LIFE</Event1Nm>
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        <GrossRevenueEvent1Amt>14485</GrossRevenueEvent1Amt>
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        <Event2Nm>RIVER RUN</Event2Nm>
        <GrossReceiptsEvent2Amt>17434</GrossReceiptsEvent2Amt>
        <GrossRevenueEvent2Amt>17434</GrossRevenueEvent2Amt>
        <OtherDirectExpensesEvent2Amt>9402</OtherDirectExpensesEvent2Amt>
        <OtherEventsTotalCnt>1</OtherEventsTotalCnt>
        <GrossReceiptsOtherEventsAmt>2430</GrossReceiptsOtherEventsAmt>
        <GrossRevenueOtherEventsAmt>2430</GrossRevenueOtherEventsAmt>
        <GrossReceiptsTotalAmt>34349</GrossReceiptsTotalAmt>
        <GrossRevenueTotalEventsAmt>34349</GrossRevenueTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>13641</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>13641</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>20708</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANGELA DELAERE</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>142248</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2173</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>500</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13238</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>158159</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE CEO AND CFO REVIEW THE FORM 990 BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ENFORCEMENT OF CONFLICTS POLICY: THE GOVERNING BODY AND SENIOR MANAGEMENT PERSONNEL IS ACCOUNTABLE TO THE AGENCY'S CONFLICT OF INTEREST POLICY, RELATED TO DISCLOSURES OF ANY BENEFIT. IF A CONFLICT OF INTEREST IS DISCOVERED, THE CEO DETERMINES THE SEVERITY OF THE CONFLICT AND DISCLOSES TO THE BOARD OF DIRECTORS AND/OR WHOMEVER IS AFFECTED. IF THE CONFLICT IS WITH A BOARD MEMBER, THE BOARD MEMBER WOULD BE PRECLUDED FROM PARTICIPATING IN ANY DISCUSSIONS OR VOTING RELATED TO A CONFLICTED ISSUE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION PROCESS: THE HUMAN RESOURCE MANAGER GATHERS INFORMATION FROM RELEVANT SOURCES TO DETERMINE COMPENSATION RANGES AND AVERAGE COMPENSATION OF ORGANIZATIONS OF SIMILAR SIZE, SIMILAR INDUSTRY AND IN SIMILAR GEOGRAPHICAL AREA. EXAMPLES OF SOURCES USED INCLUDE GLASSDOOR, LINKEDIN, NATIONAL AND STATE NON-PROFIT SALARY AND BENEFIT COMPENSATION REPORTS, INDEED.COM. A COMPENSATION RANGE IS SET AND THE COMPENSATION OFFER IS DETERMINED BASED ON QUALIFICATIONS AND EXPERIENCE. THE HUMAN RESOURCE MANAGER PROPOSES A COMPENSATION OFFER TO THE EXECUTIVE COMMITTEE FOR CONSIDERATION. FINAL APPROVAL FOR THE COMPENSATION OFFER COMES FROM THE EXECUTIVE COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS DISCLOSURE EXPLANATION: FORM 990 AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT ADJUSTMENT -69,575.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
