<?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>2023-11-15T15:21:23-06:00</ReturnTs>
    <TaxPeriodEndDt>2022-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>340677006</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>MALONEY NOVOTNY LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1111 SUPERIOR AVE SUITE 700</AddressLine1Txt>
        <CityNm>CLEVELAND</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>441142540</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>340714649</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>THE CENTER FOR HEALTH AFFAIRS</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>CENT</BusinessNameControlTxt>
      <PhoneNum>2166966900</PhoneNum>
      <USAddress>
        <AddressLine1Txt>1226 HURON RD</AddressLine1Txt>
        <CityNm>CLEVELAND</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44115</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>BRIAN LANE</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>2166966900</PhoneNum>
      <SignatureDt>2023-11-15</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>BRIAN</PersonFirstNm>
        <PersonLastNm>LANE</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>CHRISTOPHER B ANDERSON</PreparerPersonNm>
      <PTIN>P00226559</PTIN>
      <PhoneNum>2163630100</PhoneNum>
    </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="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>BRIAN LANE</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>1226 HURON RD</AddressLine1Txt>
        <CityNm>CLEVELAND</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44115</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>16929304</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.CHANET.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1918</FormationYr>
      <LegalDomicileStateCd>OH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO IMPLEMENT PROGRAMS TO IMPROVE HEALTHCARE IN NORTHEAST OHIO. PROGRAMS INCLUDE WORKFORCE &amp; REIMBURSEMENT, CHARITY CARE, EMERGENCY PREPAREDNESS, AND WAGE &amp; SALARY SURVEYS.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>14</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>13</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>1354639</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1136555</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>1608282</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>1345813</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>5018110</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>-15780</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>11084502</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>11405971</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>19065533</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>13872559</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>563558</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>372039</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>0</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>0</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>2561193</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>2144422</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>3124751</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>2516461</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>15940782</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>11356098</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>53874330</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>64286358</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>8264205</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>8526255</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>45610125</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>55760103</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>THE MISSION OF THE ORGANIZATION IS TO IMPLEMENT PROGRAMS AND SERVICES TO IMPROVE HEALTHCARE THROUGHOUT NORTHEAST OHIO.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>2002237</ExpenseAmt>
      <GrantAmt>372039</GrantAmt>
      <RevenueAmt>12751784</RevenueAmt>
      <Desc>THE ORGANIZATION'S EXEMPT PURPOSE IS TO PROVIDE PROGRAMS AND SERVICES TO THE COMMUNITY THAT IMPROVE HEALTHCARE SERVICES IN NORTHEAST OHIO. EXAMPLES OF PROGRAMS AND SERVICES INCLUDE HEALTHCARE WORKFORCE ISSUES, REIMBURSEMENT TO HEALTHCARE PROVIDERS, CHARITY CARE, COMMUNITY EMERGENCY PREPAREDNESS, AND WAGE AND SALARY SURVEYS.</Desc>
      <TotalProgramServiceExpensesAmt>2002237</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">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</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 referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>9</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <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>14</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>13</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>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <OwnWebsiteInd>X</OwnWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>BRIAN LANE</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>2166966900</PhoneNum>
        <USAddress>
          <AddressLine1Txt>1226 HURON RD</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44115</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>AIRICA STEED</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JERRY KELSHEIMER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JANICE MURPHY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR SANDEEP PALAKODETI</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRIS MCKENNA</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AL MATYAS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MELISSA KLINE</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VALDA CHRISTIAN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JILL DIETRICH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR TERESA DEWS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK MALLOY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN LANE</PersonNm>
        <TitleTxt>PRESIDENT &amp; SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>30.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>543031</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19166</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR DAN SIMON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RALPH DISE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARIO FRANCO</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>35.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>398637</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18591</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TRACY WISE</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>232957</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15452</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LESLIE FORNERIS</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>184533</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13704</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEBORA CURTIS</PersonNm>
        <TitleTxt>DIRECTOR, FINANCIAL OPERAT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>134608</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9455</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ENDRIT META</PersonNm>
        <TitleTxt>DIR.-DATA AND TECHNOLOGY</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>115802</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>4643</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTINE DODD</PersonNm>
        <TitleTxt>EXEC.DIR.-MEMBER SERVICES</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>149279</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5956</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>1758847</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>86967</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <MembershipDuesAmt>174564</MembershipDuesAmt>
      <GovernmentGrantsAmt>953794</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>8197</AllOtherContributionsAmt>
      <TotalContributionsAmt>1136555</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>FEES FOR SHARED SERVICES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1303518</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1303518</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER PROGRAM FEES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>42295</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>42295</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>1345813</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>454751</TotalRevenueColumnAmt>
        <ExclusionAmt>454751</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2586214</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>3036214</SecuritiesAmt>
        <OtherAmt>20531</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-450000</SecuritiesAmt>
        <OtherAmt>-20531</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-470531</TotalRevenueColumnAmt>
        <ExclusionAmt>-470531</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>INC. FROM SUBSIDIARY</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>11405971</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>11405971</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>11405971</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>13872559</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>12751784</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-15780</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>372039</TotalAmt>
        <ProgramServicesAmt>372039</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>11000</TotalAmt>
        <ManagementAndGeneralAmt>11000</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>28501</TotalAmt>
        <ProgramServicesAmt>28501</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>11873</TotalAmt>
        <ProgramServicesAmt>7274</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4599</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>29061</TotalAmt>
        <ManagementAndGeneralAmt>29061</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>29757</TotalAmt>
        <ProgramServicesAmt>19342</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10415</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>2595</TotalAmt>
        <ProgramServicesAmt>2595</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>9007</TotalAmt>
        <ProgramServicesAmt>9007</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <OtherExpensesGrp>
        <Desc>FEES FOR SHARED SERVICE</Desc>
        <TotalAmt>1311855</TotalAmt>
        <ProgramServicesAmt>852706</ProgramServicesAmt>
        <ManagementAndGeneralAmt>459149</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CONTRACT SVCS-STAFF&amp;BEN</Desc>
        <TotalAmt>571981</TotalAmt>
        <ProgramServicesAmt>571981</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SHARED SVCS-ACCTG.&amp;HR</Desc>
        <TotalAmt>122060</TotalAmt>
        <ProgramServicesAmt>122060</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES</Desc>
        <TotalAmt>16732</TotalAmt>
        <ProgramServicesAmt>16732</ProgramServicesAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>2516461</TotalAmt>
        <ProgramServicesAmt>2002237</ProgramServicesAmt>
        <ManagementAndGeneralAmt>514224</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>867947</BOYAmt>
        <EOYAmt>1645459</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>102316</BOYAmt>
        <EOYAmt>103634</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>24296</BOYAmt>
        <EOYAmt>24924</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>5227503</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3870345</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1474439</BOYAmt>
        <EOYAmt>1357158</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>8898746</BOYAmt>
        <EOYAmt>7242626</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>42506586</BOYAmt>
        <EOYAmt>53912557</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>53874330</BOYAmt>
        <EOYAmt>64286358</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>4896</BOYAmt>
        <EOYAmt>6071</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>727787</BOYAmt>
        <EOYAmt>607611</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>7531522</BOYAmt>
        <EOYAmt>7912573</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>8264205</BOYAmt>
        <EOYAmt>8526255</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>45610125</BOYAmt>
        <EOYAmt>55760103</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>45610125</BOYAmt>
        <EOYAmt>55760103</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>53874330</BOYAmt>
        <EOYAmt>64286358</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>11356098</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-1206120</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>1075658</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>970094</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1220904</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1354639</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1136555</CurrentTaxYearAmt>
        <TotalAmt>5757850</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>1075658</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>970094</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1220904</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1354639</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1136555</CurrentTaxYearAmt>
        <TotalAmt>5757850</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>5757850</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>209</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3002040</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5000300</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>454751</CurrentTaxYearAmt>
        <TotalAmt>8457300</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>7052678</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3516064</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4365806</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11084202</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11405971</CurrentTaxYearAmt>
        <TotalAmt>37424721</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>51639871</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>9697000</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.11150</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.13920</PublicSupportPY170Pct>
      <TenPctFactsCrcmstncsTestCYInd>X</TenPctFactsCrcmstncsTestCYInd>
      <FactsAndCircumstancesTestTxt>10% FACTS AND CIRCUMSTANCES TEST - THE CENTER SUBMITS THAT IT MEETS THE REQUIREMENTS OF TREASURY REGULATION SECTION 1.170A-9(F)(3). FOR 2022, THE CENTER'S PUBLIC SUPPORT PERCENTAGE OF 11.15% EXCEEDS THE REQUIRED 10% AND DECREASED FROM 2021 MAINLY BECAUSE OF THE ACCOUNTING REQUIREMENT TO REFLECT THE INCOME FROM A FOR-PROFIT SUBSIDIARY ON THE CENTER'S BOOKS AND BECAUSE OF A DIVIDEND FROM ITS SUBSIDIARY THAT THE CENTER USES FOR ITS PROGRAMS. FURTHER, THE CENTER OPERATES TO ATTRACT NEW AND CONTINUING GOVERNMENTAL SUPPORT ON AN ON-GOING BASIS. THE CENTER'S GOVERNING BODY IS COMPRISED OF INDIVIDUALS THAT REPRESENT THE BROAD INTERESTS OF THE PUBLIC RATHER THAN THE INTERESTS OF A SMALL NUMBER OF INDIVIDUALS. FINALLY, THE CENTER LESSENS THE BURDENS OF GOVERNMENT BY ADMINISTERING THE EMERGENCY PREPAREDNESS GRANTS FOR NORTHEASTERN OHIO HEALTHCARE INSTITUTIONS FROM THE OFFICE OF THE U.S. ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE AND THE OHIO DEPARTMENT OF HEALTH.</FactsAndCircumstancesTestTxt>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MISCREVINCFROM SUB - 2018 AMOUNT: $ 7,052,678. 2019 AMOUNT: $ 3,516,064. 2020 AMOUNT: $ 4,365,806. 2021 AMOUNT: $ 11,084,202. 2022 AMOUNT: $ 11,405,971.</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">
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>4517568</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3293046</DepreciationAmt>
        <BookValueAmt>1224522</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>709935</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>577299</DepreciationAmt>
        <BookValueAmt>132636</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>1357158</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>INVESTMENT IN SUBSIDIARIES</Desc>
        <BookValueAmt>53912557</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>53912557</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO/FROM AFFILIATED ORGANIZATIONS</Desc>
        <Amt>7912573</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>7912573</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>12666439</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-1206120</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-1206120</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>13872559</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>13872559</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>2516461</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>2516461</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>2516461</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>FIN 48 (ASC 740) FOOTNOTE - THE CENTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE CENTER BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2022, THE CENTER'S INCOME TAX AND INFORMATIONAL RETURNS REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE, AS WELL AS STATE AND LOCAL TAXING AUTHORITIES, GENERALLY FOR THREE YEARS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASHTABULA COUNTY MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2420 LAKE</AddressLine1Txt>
          <CityNm>ASHTABULA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44044</ZIPCd>
        </USAddress>
        <RecipientEIN>340726081</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>17594</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>AVON HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>33300 CLEVELAND CLINIC BLVD</AddressLine1Txt>
          <CityNm>AVON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44011</ZIPCd>
        </USAddress>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>6768</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CLEVELAND CLINIC FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>9500 EUCLID AVE</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44106</ZIPCd>
        </USAddress>
        <RecipientEIN>340714585</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>26062</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>EUCLID HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>18901 LAKESHORE BLVD</AddressLine1Txt>
          <CityNm>EUCLID</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44119</ZIPCd>
        </USAddress>
        <RecipientEIN>340714593</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>30690</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>FAIRVIEW HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>18101 LORAIN AVE</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44111</ZIPCd>
        </USAddress>
        <RecipientEIN>340714585</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10280</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HILLCREST HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>6780 MAYFIELD RD</AddressLine1Txt>
          <CityNm>MAYFIELD HTS</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44124</ZIPCd>
        </USAddress>
        <RecipientEIN>340714593</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>15354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>LUTHERAN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>17360 W 25TH ST</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44113</ZIPCd>
        </USAddress>
        <RecipientEIN>340714684</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>20301</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SOUTH POINTE HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>20000 HARVARD</AddressLine1Txt>
          <CityNm>WARRENSVILLE HTS</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44122</ZIPCd>
        </USAddress>
        <RecipientEIN>340714593</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>METROHEALTH MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2500 METROHEALTH DR</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44109</ZIPCd>
        </USAddress>
        <RecipientEIN>346004382</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>20354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SOUTHWEST GENERAL HEALTH CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>18697 BAGLEY RD</AddressLine1Txt>
          <CityNm>MIDDLEBURG HTS</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44130</ZIPCd>
        </USAddress>
        <RecipientEIN>340753531</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>11881</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TRI POINT MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>7590 AUBURN</AddressLine1Txt>
          <CityNm>CONCORD</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44077</ZIPCd>
        </USAddress>
        <RecipientEIN>341425870</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>WEST MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>36000 EUCLID AVE</AddressLine1Txt>
          <CityNm>WILLOUGHBY</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44094</ZIPCd>
        </USAddress>
        <RecipientEIN>341425870</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH AHUJA MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3999 RICHMOND RD</AddressLine1Txt>
          <CityNm>BEACHWOOD</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44122</ZIPCd>
        </USAddress>
        <RecipientEIN>264827222</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>11028</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH BEDFORD MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>44 BLAINE ST</AddressLine1Txt>
          <CityNm>BEDFORD</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44146</ZIPCd>
        </USAddress>
        <RecipientEIN>341271115</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>5329</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH ELYRIA MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>630 E RIVER RD</AddressLine1Txt>
          <CityNm>ELYRIA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44035</ZIPCd>
        </USAddress>
        <RecipientEIN>340714612</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>12256</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH GEAUGA MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>13207 RAVENNA RD</AddressLine1Txt>
          <CityNm>CHARDON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44024</ZIPCd>
        </USAddress>
        <RecipientEIN>340816492</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH PARMA MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>7007 POWERS</AddressLine1Txt>
          <CityNm>PARMA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44129</ZIPCd>
        </USAddress>
        <RecipientEIN>340827442</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>11559</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH CLEVELAND MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>11100 EUCLID AVE</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44106</ZIPCd>
        </USAddress>
        <RecipientEIN>341567805</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>15354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH RAINBOW BABIES &amp; CHILDRENS HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>11100 EUCLID AVE</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44106</ZIPCd>
        </USAddress>
        <RecipientEIN>341567805</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>12237</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MARYMOUNT HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>6801 BRECKSVILLE RD</AddressLine1Txt>
          <CityNm>INDEPENDENCE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44131</ZIPCd>
        </USAddress>
        <RecipientEIN>340714458</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>11049</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ST VINCENT CHARITY MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2351 E22ND ST</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44115</ZIPCd>
        </USAddress>
        <RecipientEIN>340714756</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MERCY HEALTH LORAIN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3700 KOLBE RD</AddressLine1Txt>
          <CityNm>LORAIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44053</ZIPCd>
        </USAddress>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>12642</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH GENEVA MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>870 WMAIN ST</AddressLine1Txt>
          <CityNm>GENEVA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44041</ZIPCd>
        </USAddress>
        <RecipientEIN>340714461</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>9354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UH CONNEAUT MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>158 W MAIN ROAD</AddressLine1Txt>
          <CityNm>CONNEAUT</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44030</ZIPCd>
        </USAddress>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>9354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MCMC LLC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>701 TECHNOLOGY DR</AddressLine1Txt>
          <CityNm>CANNONSBURG</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15317</ZIPCd>
        </USAddress>
        <CashGrantAmt>36730</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>TECH.SVCS.FOR EMER.PREP.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MERCY HEALTH-ALLEN MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>200 W LORAIN ST</AddressLine1Txt>
          <CityNm>OBERLIN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44074</ZIPCd>
        </USAddress>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>9354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>EMER.PREPAREDNESS</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>25</Total501c3OrgCnt>
      <TotalOtherOrgCnt>1</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITORING THE USE OF GRANT FUNDS - THE GRANT IS SUBJECT TO COMPLIANCE AND REGULATION STANDARDS ESTABLISHED BY THE OHIO DEPARTMENT OF HEALTH AND THE STATE OF OHIO. THE STATE OF OHIO REQUIRES QUARTERLY REPORTS TO BE SUBMITTED AND APPROVED BY THE OHIO DEPARTMENT OF HEALTH TO ENSURE THE ORGANIZATION IS IN COMPLIANCE WITH FEDERAL REGULATIONS. IN ADDITION, AN INDEPENDENT AUDIT IS OBTAINED ANNUALLY TO MONITOR THE ORGANIZATION'S COMPLIANCE WITH ESTABLISHED REGULATIONS. FINALLY, THE ORGANIZATION HAS TWO FULL-TIME EMPLOYEES WHO COMMIT 100 PERCENT OF THEIR TIME TO MONITOR AND ADMINISTER THE GRANT.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRIAN LANE</PersonNm>
        <TitleTxt>PRESIDENT &amp; SECRETARY</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>391782</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>141249</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>10000</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>9150</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10016</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>562197</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARIO FRANCO</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>273865</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>116772</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>8000</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>8495</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10096</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>417228</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TRACY WISE</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>184206</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>48751</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>5798</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>9654</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>248409</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LESLIE FORNERIS</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>157143</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>27390</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>4962</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>8742</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>198237</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTINE DODD</PersonNm>
        <TitleTxt>EXEC.DIR.-MEMBER SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>149179</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>100</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>4500</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>1456</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>155235</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>DEFERRED COMPENSATION - THROUGH A RELATED ENTITY, THE INDIVIDUALS LISTED IN PART II PARTICIPATE IN A DEFERRED COMPENSATION PLAN.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEW OF FORM 990 - FORM 990 IS DISTRIBUTED VIA E-MAIL TO ALL OFFICERS AND THE INDIVIDUAL BOARD MEMBERS FOR REVIEW. THE CEO, COO, AND THE VP OF FINANCE REVIEW FORM 990 IN DETAIL WITH THE MEMBERS OF THE BUDGET AND FINANCE COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITORING AND ENFORCEMENT OF CONFLICT POLICY - ANNUALLY, THE ORGANIZATION OBTAINS A WRITTEN STATEMENT FROM TRUSTEES, OFFICERS, AND KEY EMPLOYEES THAT THEY ARE IN COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION REVIEW AND APPROVAL - THE ORGANIZATION USES SALARY SURVEYS TO DETERMINE THE COMPENSATION FOR ALL EMPLOYEES AND COMPENSATION CONSULTANTS TO DETERMINE COMPENSATION FOR KEY EMPLOYEES AND OFFICERS. IN ADDITION, COMPENSATION FOR THE CEO AND OTHER OFFICERS IS REVIEWED BY A COMPENSATION COMMITTEE CONSISTING OF INDEPENDENT TRUSTEES OF THE BOARD. THE COMPENSATION COMMITTEE DOCUMENTS DISCUSSIONS AND DELIBERATIONS IN THE COMMITTEE'S MINUTES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABILITY OF DOCUMENTS - THE ORGANIZATION MAKES FORM 990 AVAILABLE FOR PUBLIC INSPECTION THROUGH ITS WEBSITE AND UPON REQUEST. THE FORM 990 INCLUDES THE ORGANIZATION'S FINANCIAL RESULTS AND BALANCE SHEET. ADDITIONAL DOCUMENTS THAT INCLUDE GOVERNANCE AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMUNITY HEALTH AFFAIRS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1226 HURON ROAD</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44115</ZIPCd>
        </USAddress>
        <EIN>311541843</EIN>
        <PrimaryActivitiesTxt>REPRESENT AND SERVE HOSPITALS AND HEALTH SYSTEMS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(6)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>N/A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HEALTHCOMP INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1226 HURON ROAD</AddressLine1Txt>
          <CityNm>CLEVELAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44115</ZIPCd>
        </USAddress>
        <EIN>341607331</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE SVCS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>1980126</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>57297375</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>HEALTHCOMP INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>571981</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>STAFF HOURS</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>HEALTHCOMP INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>122060</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>STAFF HRS.&amp;INV.</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
