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      <Form990PartVIISectionAGrp>
        <PersonNm>ERIC LEWIS</PersonNm>
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      <Form990PartVIISectionAGrp>
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      <Form990PartVIISectionAGrp>
        <PersonNm>TODD WAGNER</PersonNm>
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      <Form990PartVIISectionAGrp>
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        <PersonNm>TRAN KHOA</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>SHARON CHAFFEE</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>PHILIP AJLOUNY</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <TotalReportableCompFromOrgAmt>3251613</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>244764</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>12</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>MADHURI MEDARAMETLA MD</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>21100 SOUTHGATE PARK BLVD</AddressLine1Txt>
            <CityNm>MAPLE HEIGHTS</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44137</ZIPCd>
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        </ContractorAddress>
        <ServicesDesc>PSYCHIATRY</ServicesDesc>
        <CompensationAmt>302775</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>MICHAEL PRIMC MD</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>38876 MENTOR AVE</AddressLine1Txt>
            <CityNm>WILLOUGHBY</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44094</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PSYCHIATRY</ServicesDesc>
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      <CntrctRcvdGreaterThan100KCnt>2</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>54560</FundraisingAmt>
      <GovernmentGrantsAmt>5726576</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>3408269</AllOtherContributionsAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>OUTPATIENT SERVICES</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>65687947</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>65687947</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>LAB SERVICES</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>1652553</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1652553</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RESIDENTIAL SERVICES</Desc>
        <BusinessCd>623990</BusinessCd>
        <TotalRevenueColumnAmt>485518</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>485518</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>67826018</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>414437</TotalRevenueColumnAmt>
        <ExclusionAmt>414437</ExclusionAmt>
      </InvestmentIncomeGrp>
      <FundraisingGrossIncomeAmt>31085</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>54560</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>58365</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-27280</TotalRevenueColumnAmt>
        <ExclusionAmt>-27280</ExclusionAmt>
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      <GrossSalesOfInventoryAmt>66036460</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>35346428</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>30690032</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>30690032</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>918961</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>918961</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueTotalAmt>918961</OtherRevenueTotalAmt>
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        <TotalRevenueColumnAmt>109011573</TotalRevenueColumnAmt>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2037178</TotalAmt>
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      <PensionPlanContributionsGrp>
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      <InformationTechnologyGrp>
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      <TravelGrp>
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        <ManagementAndGeneralAmt>9458</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
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        <ManagementAndGeneralAmt>3219</ManagementAndGeneralAmt>
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      <InterestGrp>
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      <OtherExpensesGrp>
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      <PublicSupportPY509Pct>0.99310</PublicSupportPY509Pct>
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      <InvestmentIncomePYPct>0.00190</InvestmentIncomePYPct>
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      <Form990ScheduleAPartVIGrp>
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        <ExplanationTxt>OTHER REVENUE - 2020 AMOUNT: $ 600,551. 2021 AMOUNT: $ 668,853. BWC REFUNDS - 2020 AMOUNT: $ 1,133,163.</ExplanationTxt>
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    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
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        <ExplanationTxt>COPIES OF THE 990 ARE DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO THE DUE DATE OF THE RETURN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD MUST FILL OUT A DISCLOSURE FORM EVERY YEAR AND THE CHIEF COMPLIANCE OFFICER MONITORS PURCHASING TO ASSURE THAT ANY POTENTIAL CONFLICTS ARE BROUGHT BEFORE THE BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE COMMITTEE OF BOARD OF DIRECTORS SETS THE SALARY OF THE CEO AFTER REVIEWING DATA FROM SALARY SURVEYS AND THE 990 TAX RETURNS FROM OTHER SIMILARLY SIZED ORGANIZATIONS IN THE STATE/REGION. THE CEO'S COMPENSATION IS OUTLINED IN THE CEO'S EMPLOYMENT AGREEMENT WHICH WAS APPROVED BY THE EXECUTIVE COMMITTEE AND BOARD OF DIRECTORS. OTHER EMPLOYEES HAVE THEIR SALARY SET, WITHIN THE BOARD APPROVED BUDGETS, BY THE CEO AFTER REVIEW OF SALARY SURVEYS AND 990 TAX RETURNS OF SIMILARLY SIZED ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS INFORMATION IS CURRENTLY AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>NO PROCESS HAS CHANGED IN CURRENT YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FAMILY PLANNING ASSOCIATION OF NORTHEAST OHIO</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>54 S STATE ST STE 203</AddressLine1Txt>
          <CityNm>PLAINSVILLE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44077</ZIPCd>
        </USAddress>
        <EIN>237061724</EIN>
        <PrimaryActivitiesTxt>FAMILY PLANNING SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NORTH EAST OHIO HEALTH SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4242 STATE ROUTE 306</AddressLine1Txt>
          <CityNm>KIRTLAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44094</ZIPCd>
        </USAddress>
        <EIN>341140997</EIN>
        <PrimaryActivitiesTxt>BEHAVIORAL HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SIGNATURE HEALTH RE HOLDINGS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4242 STATE ROUTE 306</AddressLine1Txt>
          <CityNm>KIRTLAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44094</ZIPCd>
        </USAddress>
        <EIN>851495841</EIN>
        <PrimaryActivitiesTxt>TITLE HOLDING COMPANY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(2)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SIGNATURE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SIGNATURE HEALTH ASHTABULA NMTC INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4242 STATE ROUTE 306</AddressLine1Txt>
          <CityNm>KIRTLAND</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44094</ZIPCd>
        </USAddress>
        <EIN>932322799</EIN>
        <PrimaryActivitiesTxt>TITLE HOLDING COMPANY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(2)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SIGNATURE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <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>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SIGNATURE HEALTH RE HOLDINGS INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>120054</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>RENT AGREEMENT</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SIGNATURE HEALTH RE HOLDINGS INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>SEE SUPPLEMENTAL INFORMATION</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SIGNATURE HEALTH ASHTABULA NMTC INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>SEE SUPPLEMENTAL INFORMATION</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SIGNATURE HEALTH ASHTABULA NMTC INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>48806</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>RENT AGREEMENT</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE R, PART V, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>SIGNATURE HEALTH AND SIGNATURE HEALTH RE HOLDINGS, INC SHARE THEIR PAID EMPLOYEES. EXPENSES ARE PAID AND REIMBURSED AMONG THE ENTITIES THROUGHOUT THE YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE R, PART V, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>SIGNATURE HEALTH AND SIGNATURE HEALTH ASHTABULA NMTC, INC SHARE THEIR PAID EMPLOYEES. EXPENSES ARE PAID AND REIMBURSED AMONG THE ENTITIES THROUGHOUT THE YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>