﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2023v6.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-04-25T10:28:23+00:00</ReturnTs>
    <TaxPeriodEndDt>2024-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>440160260</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Forvis Mazars LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>910 E St Louis 200 PO Box 1190</AddressLine1Txt>
        <CityNm>Springfield</CityNm>
        <StateAbbreviationCd>MO</StateAbbreviationCd>
        <ZIPCd>658062523</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>231889724</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>North Penn Comprehensive Health Services</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>NORT</BusinessNameControlTxt>
      <PhoneNum>5706621948</PhoneNum>
      <USAddress>
        <AddressLine1Txt>40 W WELLSBORO ST</AddressLine1Txt>
        <CityNm>MANSFIELD</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>16933</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Ronald Gilbert</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <SignatureDt>2025-04-25</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Krystal Creach</PreparerPersonNm>
      <PTIN>P01248198</PTIN>
      <PhoneNum>4178658701</PhoneNum>
      <PreparationDt>2025-04-25</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="IRS990" softwareId="23017437" softwareVersionNum="2023v6.0">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>LAUREL HEALTH CENTERS</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfcrBusinessName>
        <BusinessNameLine1Txt>JAMES NOBLES</BusinessNameLine1Txt>
      </PrincipalOfcrBusinessName>
      <USAddress>
        <AddressLine1Txt>40 W WELLSBORO ST</AddressLine1Txt>
        <CityNm>MANSFIELD</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>16933</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>26061463</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.LAURELHC.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1973</FormationYr>
      <LegalDomicileStateCd>PA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>OUR MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE BY PROVIDING WORLD-CLASS CARE IN A COMPASSIONATE, PATIENT-CENTERED ENVIRONMENT.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>11</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>237</TotalEmployeeCnt>
      <TotalVolunteersCnt>11</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>4490041</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>3426105</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>21646317</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>22292973</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>251200</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>342385</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>26387558</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>26061463</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>17458907</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>18470604</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>8442906</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>9438181</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>25901813</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>27908785</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>485745</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1847322</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>25818508</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>24822512</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>9028523</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>9285221</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>16789985</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>15537291</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>NORTH PENN COMPREHENSIVE HEALTH SERVICES MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE BY PROVIDING WORLD-CLASS CARE IN A COMPASSIONATE, PATIENT-CENTERED ENVIRONMENT.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>14061644</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>10530268</RevenueAmt>
      <Desc>LAUREL HEALTH CENTERS PROVIDES HEALTH CARE SERVICES THROUGH 9 FEDERALLY QUALIFIED HEALTH CENTER LOCATIONS. IN 2024, THE LAUREL HEALTH CENTERS PERFORMED 58,252 FAMILY MEDICINE VISITS, 4,381 PEDIATRIC VISITS AND 4,671 CHIROPRACTIC VISITS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>3437448</ExpenseAmt>
        <GrantAmt>0</GrantAmt>
        <RevenueAmt>3090657</RevenueAmt>
        <Desc>LAUREL HEALTH CENTERS PROVIDES DENTAL CARE SERVICES AT 4 FEDERALLY QUALIFIED HEALTH CENTER LOCATIONS. IN 2024, THE LAUREL HEALTH CENTERS PERFORMED 17,772 DENTAL VISITS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>2532012</ExpenseAmt>
        <GrantAmt>0</GrantAmt>
        <RevenueAmt>2832394</RevenueAmt>
        <Desc>LAUREL HEALTH PROVIDES BEHAVIORAL HEALTH CARE SERVICES AT 7 FEDERALLY QUALIFIED HEALTH CENTER LOCATIONS AND SEVERAL SCHOOLS. IN 2024, THE LAUREL HEALTH CENTERS PERFORMED 18,121 BEHAVIORAL HEALTH VISITS.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>2237960</ExpenseAmt>
        <GrantAmt>0</GrantAmt>
        <RevenueAmt>5839654</RevenueAmt>
        <Desc>LAUREL HEALTH CENTERS OPERATED A 340B DRUG PROGRAM THAT FILLED 6,910 QUALIFIED PRESCRIPTIONS.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>2237960</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcRevenueAmt>5839654</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>22269064</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <DonorAdvisedFundInd>false</DonorAdvisedFundInd>
      <ConservationEasementsInd>false</ConservationEasementsInd>
      <CollectionsOfArtInd>false</CollectionsOfArtInd>
      <CreditCounselingInd>false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd>false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd>false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="IRS990ScheduleK1">true</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>false</InvestTaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>34</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>237</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>11</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>PA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>RONALD GILBERT</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5706621948</PhoneNum>
        <USAddress>
          <AddressLine1Txt>40 W WELLSBORO ST</AddressLine1Txt>
          <CityNm>MANSFIELD</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16933</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>DONNA WILSON</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JASON KRISE</PersonNm>
        <TitleTxt>CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JODY THOMAS</PersonNm>
        <TitleTxt>V. CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS THOMPSON III</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>J DENNIS MURRAY PHD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLY IRWIN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEVIN ABRAMS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY JOHNS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KRISTOPHER KAUFMAN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lauren Egleston</PersonNm>
        <TitleTxt>Director End 07/23</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MEGAN WELLS-WILLIAMS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SEAN SEMBER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANNE LOUDENSLAGER</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>152880</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36053</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES NOBLES</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>266185</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13297</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RONALD GILBERT</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>198231</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20597</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GEORGE DY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>589332</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42148</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES MANNING</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>441310</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44700</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KYLE UNGVARSKY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>459583</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42145</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LARA JAUSSI</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>415982</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43537</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>YEKALO BEYENE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>292573</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24198</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2816076</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>266675</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>31</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>64523</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>3083643</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>277939</AllOtherContributionsAmt>
      <TotalContributionsAmt>3426105</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>16056126</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>16056126</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACT PHARMACY</Desc>
        <BusinessCd>446110</BusinessCd>
        <TotalRevenueColumnAmt>6020541</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6020541</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER PROGRAM REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>216306</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>216306</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>22292973</TotalProgramServiceRevenueAmt>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>319320</TotalRevenueColumnAmt>
        <ExclusionAmt>319320</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>23065</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>23065</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>23065</TotalRevenueColumnAmt>
        <ExclusionAmt>23065</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>26061463</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>22292973</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>342385</ExclusionAmt>
      </TotalRevenueGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>687243</TotalAmt>
        <ManagementAndGeneralAmt>687243</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>13744580</TotalAmt>
        <ProgramServicesAmt>11058539</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2686041</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>476437</TotalAmt>
        <ProgramServicesAmt>381511</ProgramServicesAmt>
        <ManagementAndGeneralAmt>94926</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2591148</TotalAmt>
        <ProgramServicesAmt>2005394</ProgramServicesAmt>
        <ManagementAndGeneralAmt>585754</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>971196</TotalAmt>
        <ProgramServicesAmt>738846</ProgramServicesAmt>
        <ManagementAndGeneralAmt>232350</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>32121</TotalAmt>
        <ManagementAndGeneralAmt>32121</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>91105</TotalAmt>
        <ManagementAndGeneralAmt>91105</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>23770</TotalAmt>
        <ManagementAndGeneralAmt>23770</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1075510</TotalAmt>
        <ProgramServicesAmt>853936</ProgramServicesAmt>
        <ManagementAndGeneralAmt>221574</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>139320</TotalAmt>
        <ProgramServicesAmt>110618</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28702</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>475996</TotalAmt>
        <ProgramServicesAmt>377932</ProgramServicesAmt>
        <ManagementAndGeneralAmt>98064</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>380027</TotalAmt>
        <ProgramServicesAmt>301735</ProgramServicesAmt>
        <ManagementAndGeneralAmt>78292</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>819896</TotalAmt>
        <ProgramServicesAmt>650983</ProgramServicesAmt>
        <ManagementAndGeneralAmt>168913</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>97745</TotalAmt>
        <ProgramServicesAmt>77608</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20137</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>133186</TotalAmt>
        <ProgramServicesAmt>105747</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27439</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>252779</TotalAmt>
        <ProgramServicesAmt>125601</ProgramServicesAmt>
        <ManagementAndGeneralAmt>127178</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>940032</TotalAmt>
        <ProgramServicesAmt>611341</ProgramServicesAmt>
        <ManagementAndGeneralAmt>328691</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>157961</TotalAmt>
        <ProgramServicesAmt>125418</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32543</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES, AND DRUGS</Desc>
        <TotalAmt>4455286</TotalAmt>
        <ProgramServicesAmt>4455286</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>215467</TotalAmt>
        <ProgramServicesAmt>171077</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44390</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES, DUES, AND SUBSCRIPTION</Desc>
        <TotalAmt>82349</TotalAmt>
        <ProgramServicesAmt>65384</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16965</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>65631</TotalAmt>
        <ProgramServicesAmt>52108</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13523</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>27908785</TotalAmt>
        <ProgramServicesAmt>22269064</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5639721</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>96377</BOYAmt>
        <EOYAmt>128309</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>6437482</BOYAmt>
        <EOYAmt>3317199</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>523395</BOYAmt>
        <EOYAmt>361201</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2115723</BOYAmt>
        <EOYAmt>2260506</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>344522</BOYAmt>
        <EOYAmt>448314</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>16994261</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>5976926</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>9984712</BOYAmt>
        <EOYAmt>11017335</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>5142064</BOYAmt>
        <EOYAmt>5941074</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1174233</BOYAmt>
        <EOYAmt>1348574</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>25818508</BOYAmt>
        <EOYAmt>24822512</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1976800</BOYAmt>
        <EOYAmt>2599229</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>3061289</BOYAmt>
        <EOYAmt>2935997</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>2222106</BOYAmt>
        <EOYAmt>2109631</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>1010634</BOYAmt>
        <EOYAmt>820836</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>757694</BOYAmt>
        <EOYAmt>819528</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>9028523</BOYAmt>
        <EOYAmt>9285221</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>16780663</BOYAmt>
        <EOYAmt>15271298</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>9322</BOYAmt>
        <EOYAmt>265993</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>16789985</BOYAmt>
        <EOYAmt>15537291</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>25818508</BOYAmt>
        <EOYAmt>24822512</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1847322</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>594628</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="23017437" softwareVersionNum="2023v6.0">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="23017437" softwareVersionNum="2023v6.0">
      <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="IRS990ScheduleD" softwareId="23017437" softwareVersionNum="2023v6.0">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>1109780</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1109780</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>9704310</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2816727</DepreciationAmt>
        <BookValueAmt>6887583</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>582253</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>457765</DepreciationAmt>
        <BookValueAmt>124488</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>4333632</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2702434</DepreciationAmt>
        <BookValueAmt>1631198</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>1264286</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>1264286</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>11017335</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Due From Third Party</Desc>
        <BookValueAmt>223000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Deferred Compensation Plan Assets</Desc>
        <BookValueAmt>373079</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Due From Related Party</Desc>
        <BookValueAmt>306046</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Right of Use Asset</Desc>
        <BookValueAmt>446449</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>1348574</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred Compensation</Desc>
        <Amt>373079</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Operating Lease Liabilities</Desc>
        <Amt>446449</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>819528</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>27459292</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>594628</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>1083642</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>1659</OtherRevenueAmt>
      <RevenueNotReportedAmt>1679929</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>25779363</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>23770</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>258330</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>282100</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>26061463</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>28968657</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>1083642</DonatedServicesUseFcltsAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>1083642</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>27885015</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>23770</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>23770</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>27908785</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990</FormAndLineReferenceDesc>
        <ExplanationTxt>Net Assets Released From Restrictions - 1659</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements</FormAndLineReferenceDesc>
        <ExplanationTxt>Temporarily Restricted Contribtuions - 258330</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="23017437" softwareVersionNum="2023v6.0">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>true</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RONALD GILBERT</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>163234</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>30411</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>4586</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8083</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12514</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>218828</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES NOBLES</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>225832</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>40353</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10624</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2673</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>279482</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANNE LOUDENSLAGER</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>128829</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>24051</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6343</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>29710</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>188933</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GEORGE DY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>352960</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>225077</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>11295</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13200</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28948</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>631480</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LARA JAUSSI</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>344496</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>50852</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20634</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13200</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>30337</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>459519</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KYLE UNGVARSKY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>364971</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>59840</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>34772</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13200</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28945</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>501728</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES MANNING</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>418310</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>23000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13200</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>31500</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>486010</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>YEKALO BEYENE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>277695</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>14878</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11673</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12525</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>316771</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 6a Compensation contingent on net earnings of the organization</FormAndLineReferenceDesc>
        <ExplanationTxt>Key Employees and Officers are paid upon a target EBITDA being reached, have a performance rating of "Meets Expectations reaches the minimum achievement of component thresholds. Highest compensated employees are paid based on billed charges for each patient visit or an amount per relative value unit.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK1" softwareId="23017437" softwareVersionNum="2023v6.0">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>HEALTH CARE FACILITIES AUTHORITY OF SAYRE</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>236633733</BondIssuerEIN>
        <BondIssuedDt>2021-06-01</BondIssuedDt>
        <IssuePriceAmt>3300000</IssuePriceAmt>
        <PurposeDesc>TROY CLINIC ASSET ACQUISTION</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>364003</RetiredAmt>
        <TotalProceedsAmt>3300000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>97811</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>3202189</CapitalExpendituresAmt>
        <SubstantialCompletionYr>2021</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>true</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="23017437" softwareVersionNum="2023v6.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d Description of other program services</FormAndLineReferenceDesc>
        <ExplanationTxt>(Expenses $ 2,237,960 including grants of $ 0)(Revenue $ 5,839,654) LAUREL HEALTH CENTERS OPERATED A 340B DRUG PROGRAM THAT FILLED 6,910 QUALIFIED PRESCRIPTIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a &amp; 15B - Process for Determining Compensation</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CEO SALARY STRUCTURE IS ANALYZED IN RELATIONSHIP TO THE LABOR MARKET USING SALARY SURVEYS. A RECOMMENDATION IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR CONSIDERATION AND APPROVAL. THE MOST RECENT COMPENSATION REVIEW WAS CONDUCTED IN 2024 AND IS REVIEWED ANNUALLY. THE CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, CHIEF DEVELOPMENT OFFICER AND CHIEF ADMINISTRATIVE OFFICER SALARY STRUCTURE IS ANALYZED IN RELATIONSHIP TO THE LABOR MARKET USING SALARY SURVEYS. A RECOMMENDATION IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR CONSIDERATION AND APPROVAL. THE MOST RECENT COMPENSATION REVIEW WAS CONDUCTED IN 2024 AND IS REVIEWED ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OF THE BOARD OF DIRECTORS OF NORTH PENN COMPREHENSIVE HEALTH SERVICES (NPCHS) ARE PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING. THE CFO REVIEWS THE FORM 990 WITH THE BOARD OF DIRECTORS AND RESPONDS TO ANY QUESTIONS. DURING THIS MEETING THE CFO THEN RECOMMENDS TO THE BOARD OF DIRECTORS THAT THE FORM 990 BE APPROVED FOR FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUALLY IN JANUARY THE COMPLIANCE OFFICER SENDS TO ALL DIRECTORS, A QUESTIONNAIRE TO BE COMPLETED AND RETURNED PROMPTLY. A REPORT IS SUBMITTED TO THE BOARD OF DIRECTORS TO NOTIFY ANY CONFLICTS OF INTEREST DISCLOSED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE CONFLICT OF INTEREST POLICY IS ALSO AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>