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      <SupportingOrgType2Ind>X</SupportingOrgType2Ind>
      <IRSWrittenDeterminationInd>X</IRSWrittenDeterminationInd>
      <SupportedOrganizationsCnt>1</SupportedOrganizationsCnt>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>Towner County Medical Center</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>450425948</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>1</GoverningDocumentListedInd>
        <SupportAmt>307300</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
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      <SupportedOrganizationsTotalCnt>1</SupportedOrganizationsTotalCnt>
      <SupportSumAmt>307300</SupportSumAmt>
      <OtherSupportSumAmt>0</OtherSupportSumAmt>
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        <PaymentSubstantialContribtrInd>0</PaymentSubstantialContribtrInd>
        <LoanDisqualifiedPersonInd>0</LoanDisqualifiedPersonInd>
        <ControlledDisqualifiedPrsnInd>0</ControlledDisqualifiedPrsnInd>
        <DisqualifiedPrsnControllIntInd>0</DisqualifiedPrsnControllIntInd>
        <DisqualifiedPrsnOwnrIntInd>0</DisqualifiedPrsnOwnrIntInd>
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      <MajorityDirTrstSupportedOrgInd>1</MajorityDirTrstSupportedOrgInd>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part I, Line 12e:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization received a written determination letter indicating that they are a Type I Supporting Organization. Due to changes to the Bylaws during Fiscal Year 2018, the Organization is now a Type II Supporting Organization.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section A, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Articles of Incorporation for the Living Center do not specifically indicate Towner County Medical Center (the Medical Center) by name as the supported organization. However, a qualifying charitable class has been defined by the verbiage "to establish, maintain, and operate a medical care center in the City of Cando, North Dakota, and to acquire lands and structure suitable for use or development for medical practice to service Towner County, North Dakota, and the surrounding area", as stated in Article 3. Further, the Articles permit the organization "to own, manage and operate housing for the aged and handicapped within Towner County, North Dakota, and to acquire lands and structures suitable for such purpose." Finally, the articles require the organization's purposes to be charitable, educational, religious, or scientific within Sec. 501(c)(3) and that no activities other than those permitted within Sec. 501(c)(3) shall be permitted. The Living Center has limited its purposes to those for the benefit of the specified class of supported organizations, and arguably the Medical Center falls within this specified class. In addition, the Living Center's Articles are similar to, but no broader than, the purposes set forth in the Articles of the Medical Center. The organization's governing documents also do not expressly permit it to benefit any other organization which is not included the charitable class defined.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>30363</OtherCostOrOtherBasisAmt>
        <BookValueAmt>30363</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1227780</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1202516</DepreciationAmt>
        <BookValueAmt>25264</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>72880</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>72880</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>99000</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>99000</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>55627</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>-149127</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>-596922</OtherRevenueAmt>
      <RevenueNotReportedAmt>-596922</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>447795</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>447795</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>190605</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>190605</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>190605</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IV, Line 2b:</FormAndLineReferenceDesc>
        <ExplanationTxt>TCLC has booked refundable security deposits in the amounts of $16,190 and $12,640 as of June 30, 2024 and 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Medical Center, Living Center, and Authority, believe they have appropriate support for any tax positions taken affecting the annual filing requirements, and as such, do not have any uncertain tax positions that are material to the combined financial statements. The Medical Center, Living Center, and Authority would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Loss on the Extinguishment of Direct Financing Lease -596,922.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Ben Bucher</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>245202</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>39600</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>10155</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>17431</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>312388</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Tammy Larson</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>169063</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>23760</BonusRelatedOrganizationsAmt>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>7370</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>22494</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>222687</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The President/CEO and CFO are paid by a related organization for services to the related organization. The related organization used one or more of the methods listed to establish their compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Tammy Larson and Ben Bucher have a business relationship with David Wolsky, Tom Belzer, Greg Westlind, Randina Bjornstad, John Peters, Mike Farbo, and Michelle Gibbens.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Members are the Class A members of the Towner County Hospital Authority.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 8b</FormAndLineReferenceDesc>
        <ExplanationTxt>There were no committees with authority to act on behalf of the governing board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO will review the draft. The 990 draft will be provided to the Board of Directors for review prior to the 990 being finalized and filed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO, CFO and board members annually disclose any interests that could give rise to conflicts. The CEO reviews the responses. Any member of the Board of Directors having a conflict of interest should not vote on the matter. The CFO does not have voting rights. If the CFO has a conflict of interest they would be asked to leave the room when discussions were held related to the conflict.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Towner County Living Center (TCLC) does not provide compensation to employees as it is paid by a related party, Towner County Medical Center (TCMC).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization makes its governing documents, conflict of interest policy and financial statements available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Housekeeping &amp; Laundry: Program service expenses 18,000. Management and general expenses 0. Fundraising expenses 0. Total expenses 18,000. Meals Expense: Program service expenses 30,000. Management and general expenses 0. Fundraising expenses 0. Total expenses 30,000. Living Center Maintenance: Program service expenses 3,600. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,600.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Loss on the Extinguishment of Direct Financing Lease -596,922.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9 and Schedule D, part XI, line 2d:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's audited financial statements are reporting a loss on the extinguishment of a direct financing lease within lease income during FY24. The direct finance lease was held with the related organization, Towner County Medical Center. The organization is reporting the loss on the extinguishment of a direct financing lease in the amount of $596,922 in part XI, line 9 and on schedule D, part XI, line 2d.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Towner County Medical Center Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 688</AddressLine1Txt>
          <CityNm>Cando</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58324</ZIPCd>
        </USAddress>
        <EIN>450425948</EIN>
        <PrimaryActivitiesTxt>Operating medical center, congregate housing and long term care facilities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Towner County Hospital Authority</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Towner County Hospital Authority</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>PO Box 688</AddressLine1Txt>
          <CityNm>Cando</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58324</ZIPCd>
        </USAddress>
        <EIN>450423303</EIN>
        <PrimaryActivitiesTxt>Furnishing of health care facilities and equipment</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 7</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
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      </IdRelatedTaxExemptOrgGrp>
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      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
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      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>