<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2022v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-07-17T12:23:11-05:00</ReturnTs>
    <TaxPeriodEndDt>2022-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>271895149</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Heveron &amp; Company CPAs PLLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>260 Plymouth Avenue South</AddressLine1Txt>
        <CityNm>Rochester</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>14608</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>166050390</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>CHS Mobile Integrated Health Care Inc</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>CHSM</BusinessNameControlTxt>
      <PhoneNum>5853344190</PhoneNum>
      <USAddress>
        <AddressLine1Txt>280 Calkins Road</AddressLine1Txt>
        <CityNm>Rochester</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>14623</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Tracey Wenzel</PersonNm>
      <PersonTitleTxt>Chairperson</PersonTitleTxt>
      <PhoneNum>5853344190</PhoneNum>
      <SignatureDt>2023-07-17</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>Tracey</PersonFirstNm>
        <PersonLastNm>Wenzel</PersonLastNm>
      </PersonFullName>
      <SSN>XXX-XX-XXXX</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Stephanie Annunziata</PreparerPersonNm>
      <PTIN>P00195472</PTIN>
      <PhoneNum>5852322956</PhoneNum>
      <PreparationDt>2023-07-07</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="5">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>Frank Manzo</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>280 Calkins Road</AddressLine1Txt>
        <CityNm>Rochester</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>14623</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>8067628</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>chsmobilehealth.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1962</FormationYr>
      <LegalDomicileStateCd>NY</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Deliver high quality, compassionate health care</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>11</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>117</TotalEmployeeCnt>
      <TotalVolunteersCnt>14</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>2427751</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1967324</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>4811811</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>5534080</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>11314</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>73043</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>12240</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>37936</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>7263116</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>7612383</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>4601086</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>4306022</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>25588</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>1984864</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>2553542</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>6585950</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>6859564</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>677166</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>752819</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>5243723</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>6299192</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>565283</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>928341</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>4678440</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>5370851</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>Deliver high quality, compassionate health care while being responsible in the planning and management of resources to improve the health of our community.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>5372663</ExpenseAmt>
      <RevenueAmt>5572016</RevenueAmt>
      <Desc>CHS Mobile Integrated Health Care is a private not-for-profit organization that operates as an independent 501(c)(3) agency. CHS was created as a part of a merger between Chili Volunteer Ambulance Service, Henrietta Volunteer Ambulance, and the Scottsville Rescue Squad. In time CHS later merged with Caledonia Ambulance and then Greece Volunteer Ambulance Service. Members of the merged agency include a mix of volunteers and employees from all areas. CHS provides emergency medical services (EMS) to the residents of Henrietta, Chili, Scottsville, Caledonia, Wheatland, Hilton and Parma. We respond 24 hours-per-day with our fleet of 20 vehicles and over 100 volunteers and employees. We cover 188 square miles and respond to over 14,000 requests for service.</Desc>
      <TotalProgramServiceExpensesAmt>5372663</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>0</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>17</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>117</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>11</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <OtherWebsiteInd>X</OtherWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Heather Lenhardt</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5853344190</PhoneNum>
        <USAddress>
          <AddressLine1Txt>280 Calkins Road</AddressLine1Txt>
          <CityNm>Rochester</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14623</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tracey Wenzel</PersonNm>
        <TitleTxt>Chairperson</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John McParlin</PersonNm>
        <TitleTxt>Vice Chairperson</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Steve Winner</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Brett Benedict</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cheryl Arilotta</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Auerhahn</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Peter Borrelli</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tammy O'Donoghue</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Geoff Cole</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mike Smith</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jason Aymerich</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Reg Allen</PersonNm>
        <TitleTxt>CEO/Chief</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>94362</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6910</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Heather Lenhardt</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>101745</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32227</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>196107</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>39137</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>7054</FederatedCampaignsAmt>
      <GovernmentGrantsAmt>1864719</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>95551</AllOtherContributionsAmt>
      <TotalContributionsAmt>1967324</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Emergency Medical Serv</Desc>
        <BusinessCd>621910</BusinessCd>
        <TotalRevenueColumnAmt>5534080</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5534080</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>5534080</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>64614</TotalRevenueColumnAmt>
        <ExclusionAmt>64614</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>463674</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>455245</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>8429</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>8429</TotalRevenueColumnAmt>
        <ExclusionAmt>8429</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>Other Income</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>37936</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>37936</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>37936</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>7612383</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5572016</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>73043</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>235244</TotalAmt>
        <ProgramServicesAmt>25318</ProgramServicesAmt>
        <ManagementAndGeneralAmt>209926</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>3386352</TotalAmt>
        <ProgramServicesAmt>2946509</ProgramServicesAmt>
        <ManagementAndGeneralAmt>428947</ManagementAndGeneralAmt>
        <FundraisingAmt>10896</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>63539</TotalAmt>
        <ProgramServicesAmt>60338</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2974</ManagementAndGeneralAmt>
        <FundraisingAmt>227</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>329513</TotalAmt>
        <ProgramServicesAmt>296249</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32177</ManagementAndGeneralAmt>
        <FundraisingAmt>1087</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>291374</TotalAmt>
        <ProgramServicesAmt>241569</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48919</ManagementAndGeneralAmt>
        <FundraisingAmt>886</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>64103</TotalAmt>
        <ManagementAndGeneralAmt>64103</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>56460</TotalAmt>
        <ManagementAndGeneralAmt>56460</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>417570</TotalAmt>
        <ProgramServicesAmt>131192</ProgramServicesAmt>
        <ManagementAndGeneralAmt>286378</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>130792</TotalAmt>
        <ProgramServicesAmt>41788</ProgramServicesAmt>
        <ManagementAndGeneralAmt>76582</ManagementAndGeneralAmt>
        <FundraisingAmt>12422</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>125428</TotalAmt>
        <ProgramServicesAmt>46171</ProgramServicesAmt>
        <ManagementAndGeneralAmt>79257</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>55409</TotalAmt>
        <ProgramServicesAmt>51168</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4241</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>97023</TotalAmt>
        <ProgramServicesAmt>97023</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>25404</TotalAmt>
        <ManagementAndGeneralAmt>25404</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>418378</TotalAmt>
        <ProgramServicesAmt>387085</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31293</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>217067</TotalAmt>
        <ProgramServicesAmt>119068</ProgramServicesAmt>
        <ManagementAndGeneralAmt>97929</ManagementAndGeneralAmt>
        <FundraisingAmt>70</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Building and Grounds</Desc>
        <TotalAmt>414986</TotalAmt>
        <ProgramServicesAmt>405049</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9937</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Vehicle Expenses</Desc>
        <TotalAmt>305675</TotalAmt>
        <ProgramServicesAmt>305675</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>175277</TotalAmt>
        <ProgramServicesAmt>175277</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Uniforms</Desc>
        <TotalAmt>24205</TotalAmt>
        <ProgramServicesAmt>24205</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>25765</TotalAmt>
        <ProgramServicesAmt>18979</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6786</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>6859564</TotalAmt>
        <ProgramServicesAmt>5372663</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1461313</ManagementAndGeneralAmt>
        <FundraisingAmt>25588</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>898795</BOYAmt>
        <EOYAmt>786437</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>440554</BOYAmt>
        <EOYAmt>41237</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <LandBldgEquipCostOrOtherBssAmt>5368648</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3162339</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>2801851</BOYAmt>
        <EOYAmt>2206309</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>1102523</BOYAmt>
        <EOYAmt>2919802</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>345407</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>5243723</BOYAmt>
        <EOYAmt>6299192</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>66993</BOYAmt>
        <EOYAmt>104765</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>498290</BOYAmt>
        <EOYAmt>487500</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>336076</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>565283</BOYAmt>
        <EOYAmt>928341</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>4678440</BOYAmt>
        <EOYAmt>5370851</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>4678440</BOYAmt>
        <EOYAmt>5370851</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>5243723</BOYAmt>
        <EOYAmt>6299192</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>752819</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-60408</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingOtherInd methodOfAccountingOtherDesc="Modified Cash">X</MethodOfAccountingOtherInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>292940</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>338171</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2813440</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1465733</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>946419</CurrentTaxYearAmt>
        <TotalAmt>5856703</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>3897077</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4278428</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4530729</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4811811</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5534080</CurrentTaxYearAmt>
        <TotalAmt>23052125</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <CurrentTaxYearMinus4YearsAmt>853623</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>899084</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>932229</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>962018</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1020905</CurrentTaxYearAmt>
        <TotalAmt>4667859</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>5043640</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5515683</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8276398</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7239562</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7501404</CurrentTaxYearAmt>
        <TotalAmt>33576687</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>33576687</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>7282</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5917</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2813</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11940</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>64614</CurrentTaxYearAmt>
        <TotalAmt>92566</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>3300</CurrentTaxYearMinus4YearsAmt>
        <TotalAmt>3300</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>10582</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5917</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2813</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11940</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>64614</CurrentTaxYearAmt>
        <TotalAmt>95866</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>-1952</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>18712</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5900</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12240</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>37936</CurrentTaxYearAmt>
        <TotalAmt>72836</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>5052270</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5540312</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8285111</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7263742</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7603954</CurrentTaxYearAmt>
        <TotalAmt>33745389</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99500</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99730</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00280</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00160</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part III, Line 12, Explanation of Other Income:</FormAndLineReferenceDesc>
        <ExplanationTxt>Subsidiary Income Other Income</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>203542</OtherCostOrOtherBasisAmt>
        <BookValueAmt>203542</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>2779104</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1591139</DepreciationAmt>
        <BookValueAmt>1187965</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1497755</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>893689</DepreciationAmt>
        <BookValueAmt>604066</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>888247</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>677511</DepreciationAmt>
        <BookValueAmt>210736</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>2206309</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Right-of-Use Assets - Finance Leases</Desc>
        <BookValueAmt>345407</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>345407</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Finance Lease Liabilities</Desc>
        <Amt>336076</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>336076</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>7551975</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-60408</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-60408</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>7612383</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>7612383</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>6859564</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>6859564</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>6859564</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Chief reviews the 990 and presents it to the Treasurer who then presents it to the Board of Directors at which time the Board resolves any and all open issues and gives their approval to file.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board annually reviews conflict of interest questionnaires completed by the Board members, employees, and volunteers and addresses any conflicts.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board annually reviews compensation packages and compares them to packages awarded at ambulance services of similar size and demographics. Final compensation packages are voted on by the Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All policies, financial statements and governing documents are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization uses the modified cash basis of accounting.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
