﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v6.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-04-04T16:36:37-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>390758449</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>WIPFLI LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>2501 W BELTLINE HWY STE 501</AddressLine1Txt>
        <CityNm>MADISON</CityNm>
        <StateAbbreviationCd>WI</StateAbbreviationCd>
        <ZIPCd>53713</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>341205791</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>ALTA CARE GROUP INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>ALTA</BusinessNameControlTxt>
      <PhoneNum>3307932487</PhoneNum>
      <USAddress>
        <AddressLine1Txt>7620 MARKET STREET 2</AddressLine1Txt>
        <CityNm>YOUNGSTOWN</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44512</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>VINCE PAOLUCCI</PersonNm>
      <PersonTitleTxt>CHIEF EXECUTIVE OFFICER</PersonTitleTxt>
      <PhoneNum>3307932487</PhoneNum>
      <SignatureDt>2025-04-03</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>QUINN DUGAN</PreparerPersonNm>
      <PTIN>P02267768</PTIN>
      <PhoneNum>6082741980</PhoneNum>
      <PreparationDt>2025-04-03</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>VINCE PAOLUCCI</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>7620 MARKET STREET 2</AddressLine1Txt>
        <CityNm>YOUNGSTOWN</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44512</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>19676568</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.ALTACAREGROUP.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1976</FormationYr>
      <LegalDomicileStateCd>OH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO SUPPORT THE SOCIAL, EMOTIONAL, BEHAVIORAL, EDUCATIONAL, AND PHYSICAL WELL-BEING OF CHILDREN, ADOLESCENTS, YOUNG ADULTS AND THEIR FAMILIES.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>12</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>12</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>324</TotalEmployeeCnt>
      <TotalVolunteersCnt>617</TotalVolunteersCnt>
      <TotalGrossUBIAmt>42020</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>700</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>13151274</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>13366487</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>5134962</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>6152527</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>60567</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>50504</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>110866</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>90276</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>18457669</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>19659794</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>11556743</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>12899218</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>6759</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>6034838</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>5997058</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>17591581</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>18896276</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>866088</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>763518</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>12541051</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>13723052</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>5358498</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>5495675</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>7182553</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>8227377</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TO SUPPORT THE SOCIAL, EMOTIONAL, BEHAVIORAL, EDUCATIONAL, AND PHYSICAL WELL-BEING OF CHILDREN, ADOLESCENTS, YOUNG ADULTS AND THEIR FAMILIES.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>8597450</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>6152527</RevenueAmt>
      <Desc>BEHAVIORAL HEALTH - THE BEHAVIORAL HEALTH PROGRAM INCLUDES OUTPATIENT SERVICES, PREVENTION, CLASSROOM CONNECTIONS, AND CAMP CHALLENGE INTENSIVE OUTPATIENT PROGRAM.OUTPATIENT SERVICES - INDIVIDUAL, GROUP COUNSELING, FAMILY COUNSELING, AND PSYCHIATRIC SERVICES ARE PROVIDED BY A STAFF OF THERAPISTS AND PHYSICIANS SKILLED IN CHILD BEHAVIOR MANAGEMENT AND FAMILY DYNAMICS. SERVICES TO BE PROVIDED ARE DETERMINED BY THE CLINICIAN AND HIS/HER CLINICAL SUPERVISOR AND CAN INCLUDE OFFICE-BASED, HOME-BASED, AND SCHOOL-BASED SETTINGS.PREVENTION - THESE SERVICES ARE ACTIVITIES THAT ARE DESIGNED TO REDUCE THE INCIDENCE FOR FUTURE PROBLEMS/DIFFICULTIES IN "AT RISK" POPULATIONS AND ARE NOT THERAPEUTIC IN AND OF THEMSELVES, BUT ARE DESIGNED TO HAVE POSITIVE IMPACT ON THE LIVES OF CHILDREN. THEY ARE TYPICALLY EDUCATION IN NATURE BUT ALSO MAY INCLUDE SUPPORTIVE, CONSULTATIVE, REFERRAL AND OTHER ACTIVITIES AS REQUIRED.CLASSROOM CONNECTIONS - A SCHOOL-BASED TEACHER CONSULTATION AND STUDENT COUNSELING PROGRAM DESIGNED TO FORWARD THE BEHAVIORAL HEALTH AND FUNCTIONING OF STUDENTS AND, IN TURN, THEIR SUCCESS IN ACHIEVING THE ACADEMIC STANDARDS.CAMP CHALLENGE INTENSIVE OUTPATIENT PROGRAM - A SUMMER AND AFTER-SCHOOL INTENSIVE OUTPATIENT COUNSELING AND THERAPEUTIC RECREATION SERVICE DESIGNED TO HELP CHILDREN WITH SERIOUS SOCIAL SKILLS DEFICITS AND SIGNIFICANT BEHAVIOR PROBLEMS THAT ARE INTERFERING WITH THEIR ABILITY TO SUCCESSFULLY FUNCTION AT HOME AND/OR SCHOOL.MRSS PROGRAM - PROVIDES RAPID, IN-PERSON, COMMUNITY BASED INTERVENTION AND SUPPORT FOR YOUTH AND FAMILIES EXPERIENCING BEHAVIORAL HEALTH CRISIS, AIMING TO DEESCALATE SITUATIONS AND PREVENT UNNECESSARY HOSPITALIZATIONS OR OUT-OF-HOME PLACEMENTS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>8608481</ExpenseAmt>
        <GrantAmt>0</GrantAmt>
        <RevenueAmt>0</RevenueAmt>
        <Desc>HEADSTART - THE OBJECTIVE OF THIS PROGRAM IS TO PROMOTE SCHOOL READINESS BY ENHANCING CHILDREN'S COGNITIVE, SOCIAL, AND EMOTIONAL DEVELOPMENT. HEAD START AND EARLY HEAD START TOGETHER SERVE PREGNANT WOMEN AND CHILDREN (BIRTH TO 5) AND THEIR FAMILIES, WHO ARE UNDER THE POVERTY LINE OR ARE ELIGIBLE FOR PUBLIC ASSISTANCE, INCLUDING HOMELESS CHILDREN, CHILDREN IN FOSTER CARE AND CHILDREN WITH DISABILITIES.</Desc>
      </ProgSrvcAccomActy2Grp>
      <TotalProgramServiceExpensesAmt>17205931</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="RetDoc1042900001">1</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="RetDoc1042900001">0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>49</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>324</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>1</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>1</Form990TFiledInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>12</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>12</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>WENDY SAUL</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>3307932487</PhoneNum>
        <USAddress>
          <AddressLine1Txt>7620 MARKET STREET 2</AddressLine1Txt>
          <CityNm>YOUNGSTOWN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44512</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>LEIGH SAMARGIA-PFLUG</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JESSICA FOSTER</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATRICK O'LEARY</PersonNm>
        <TitleTxt>FIRST VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLY FRAMMARTINO</PersonNm>
        <TitleTxt>SECOND VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK GALLAGHER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL CAFARO</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES GIBBS</PersonNm>
        <TitleTxt>BOARD MEMBER (THRU 05/24)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD HURA</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DOROTHY MACKLIN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>IAN MCKENNA</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN MOORER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS PHILLIPS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEVEN YACAVONE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WENDY SAUL</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>107496</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12065</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH SHOROKEY</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>138780</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13235</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ABIGALE BENSON</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <AverageHoursPerWeekRt>36.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>152027</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10967</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK DEMETRIOS</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <AverageHoursPerWeekRt>30.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>135062</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12298</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>533365</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>48565</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>4</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NESCO RESOURCE LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 901372</AddressLine1Txt>
            <CityNm>CLEVELAND</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44190</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT LABOR</ServicesDesc>
        <CompensationAmt>506980</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NUTRITION INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>580 WENDEL RD STE 100</AddressLine1Txt>
            <CityNm>IRWIN</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>15642</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CATERING OF MEALS</ServicesDesc>
        <CompensationAmt>489915</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>EASTER SEAL SOCIETY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>299 EDWARDS AVE</AddressLine1Txt>
            <CityNm>YOUNGSTOWN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44502</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MULTI DISABILITY SERVICES</ServicesDesc>
        <CompensationAmt>371371</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JEROME UNDERWOOD</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>831 MIAMA AVE</AddressLine1Txt>
            <CityNm>YOUNGSTOWN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44505</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>JANITORIAL SERVICES</ServicesDesc>
        <CompensationAmt>231164</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>INVOLTA</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 1986</AddressLine1Txt>
            <CityNm>CEDAR RAPIDS</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>51406</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MANAGED IT SERVICES</ServicesDesc>
        <CompensationAmt>105928</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>13260491</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>105996</AllOtherContributionsAmt>
      <NoncashContributionsAmt>40962</NoncashContributionsAmt>
      <TotalContributionsAmt>13366487</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>BEHAVIORAL HEALTH REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>6023071</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6023071</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RENTAL INCOME</Desc>
        <BusinessCd>456199</BusinessCd>
        <TotalRevenueColumnAmt>99713</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>99713</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>29743</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>29743</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>6152527</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>50339</TotalRevenueColumnAmt>
        <ExclusionAmt>50339</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>16939</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>16774</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>16939</SecuritiesAmt>
        <OtherAmt>-16774</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>165</TotalRevenueColumnAmt>
        <ExclusionAmt>165</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>EMPLOYEE LEASE REVENUE</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>40320</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>40320</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>PARKING LOT RENTAL</Desc>
        <BusinessCd>812930</BusinessCd>
        <TotalRevenueColumnAmt>1700</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>1700</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>48256</TotalRevenueColumnAmt>
        <ExclusionAmt>48256</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>90276</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>19659794</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6152527</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>42020</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>98760</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>275538</TotalAmt>
        <ManagementAndGeneralAmt>269333</ManagementAndGeneralAmt>
        <FundraisingAmt>6205</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>9649932</TotalAmt>
        <ProgramServicesAmt>8962529</ProgramServicesAmt>
        <ManagementAndGeneralAmt>687272</ManagementAndGeneralAmt>
        <FundraisingAmt>131</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>327428</TotalAmt>
        <ProgramServicesAmt>306643</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20785</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1783506</TotalAmt>
        <ProgramServicesAmt>1616915</ProgramServicesAmt>
        <ManagementAndGeneralAmt>166591</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>862814</TotalAmt>
        <ProgramServicesAmt>776931</ProgramServicesAmt>
        <ManagementAndGeneralAmt>85460</ManagementAndGeneralAmt>
        <FundraisingAmt>423</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>2184</TotalAmt>
        <ProgramServicesAmt>2184</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>49875</TotalAmt>
        <ProgramServicesAmt>49875</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1677459</TotalAmt>
        <ProgramServicesAmt>1677459</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>36700</TotalAmt>
        <ProgramServicesAmt>36700</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>669134</TotalAmt>
        <ProgramServicesAmt>617524</ProgramServicesAmt>
        <ManagementAndGeneralAmt>51610</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>503917</TotalAmt>
        <ProgramServicesAmt>313745</ProgramServicesAmt>
        <ManagementAndGeneralAmt>190172</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>615059</TotalAmt>
        <ProgramServicesAmt>554856</ProgramServicesAmt>
        <ManagementAndGeneralAmt>60203</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>221048</TotalAmt>
        <ProgramServicesAmt>206250</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14798</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>94763</TotalAmt>
        <ProgramServicesAmt>94763</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>2849</TotalAmt>
        <ProgramServicesAmt>2849</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>424892</TotalAmt>
        <ProgramServicesAmt>424892</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>140464</TotalAmt>
        <ProgramServicesAmt>125226</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15238</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PROGRAM EXPENSES</Desc>
        <TotalAmt>622224</TotalAmt>
        <ProgramServicesAmt>622224</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>616395</TotalAmt>
        <ProgramServicesAmt>616395</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES &amp; DUES</Desc>
        <TotalAmt>31486</TotalAmt>
        <ProgramServicesAmt>28772</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2714</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>RECRUITMENT</Desc>
        <TotalAmt>30239</TotalAmt>
        <ProgramServicesAmt>30239</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>258370</TotalAmt>
        <ProgramServicesAmt>138960</ProgramServicesAmt>
        <ManagementAndGeneralAmt>119410</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>18896276</TotalAmt>
        <ProgramServicesAmt>17205931</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1683586</ManagementAndGeneralAmt>
        <FundraisingAmt>6759</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3770344</BOYAmt>
        <EOYAmt>4755269</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>361348</BOYAmt>
        <EOYAmt>562334</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>1516553</BOYAmt>
        <EOYAmt>1703377</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1002098</BOYAmt>
        <EOYAmt>705268</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>241670</BOYAmt>
        <EOYAmt>240961</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>7916854</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>5161015</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>3130230</BOYAmt>
        <EOYAmt>2755839</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>1519106</BOYAmt>
        <EOYAmt>2044473</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>999702</BOYAmt>
        <EOYAmt>955531</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>12541051</BOYAmt>
        <EOYAmt>13723052</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>4011877</BOYAmt>
        <EOYAmt>4002654</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>37594</BOYAmt>
        <EOYAmt>32969</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>326514</BOYAmt>
        <EOYAmt>516209</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>982513</BOYAmt>
        <EOYAmt>943843</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>5358498</BOYAmt>
        <EOYAmt>5495675</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>7182553</BOYAmt>
        <EOYAmt>8031895</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <EOYAmt>195482</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>7182553</BOYAmt>
        <EOYAmt>8227377</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>12541051</BOYAmt>
        <EOYAmt>13723052</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>763518</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>160824</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>120482</DonatedServicesAndUseFcltsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>9874316</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12543247</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12778873</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13151274</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13366487</CurrentTaxYearAmt>
        <TotalAmt>61714197</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>9874316</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12543247</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12778873</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>13151274</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13366487</CurrentTaxYearAmt>
        <TotalAmt>61714197</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>61714197</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>25654</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>20694</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27919</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>39356</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>50339</CurrentTaxYearAmt>
        <TotalAmt>163962</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <CurrentTaxYearMinus3YearsAmt>15377</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>131055</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1089</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>147521</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus3YearsAmt>29764</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>36096</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>69106</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>48256</CurrentTaxYearAmt>
        <TotalAmt>183222</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>62208902</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>20578795</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.99200</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99210</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>70233</OtherCostOrOtherBasisAmt>
        <BookValueAmt>70233</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>5006402</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3191357</DepreciationAmt>
        <BookValueAmt>1815045</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>633516</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>391998</DepreciationAmt>
        <BookValueAmt>241518</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1713397</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1199878</DepreciationAmt>
        <BookValueAmt>513519</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>493306</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>377782</DepreciationAmt>
        <BookValueAmt>115524</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>2755839</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT-OF-USE-ASSET, OPERATING</Desc>
        <BookValueAmt>955531</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>955531</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>OPERATING LEASE OBLIGATIONS</Desc>
        <Amt>943843</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>943843</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>22981248</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>160824</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>3160630</DonatedServicesAndUseFcltsAmt>
      <RevenueNotReportedAmt>3321454</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>19659794</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>19659794</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>21936424</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>3040148</DonatedServicesUseFcltsAmt>
      <ExpensesNotReportedAmt>3040148</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>18896276</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>18896276</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS REQURED TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION HAS DETERMINED THERE ARE NO AMOUNTS TO RECORD AS ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ABIGALE BENSON</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>152027</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7757</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3210</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>162994</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOSEPH SHOROKEY</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>133780</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7235</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>6000</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>152015</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>457(F) PLAN - ER CONTRIBUTIONS, JOE SHOROKEY, $9,616 WILL NOT BE CONTRIBUTED UNTIL ALL OBLIGATIONS HAVE BEEN MET. PAYOUT TO OCCUR IN 2025.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>SUPPLIES</Desc>
        <ContributionCnt>409</ContributionCnt>
        <NoncashContributionsRptF990Amt>40962</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>0</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, COLUMN (B):</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NUMBER OF CONTRIBUTIONS WAS ESTIMATED AT $100 PER CONTRIBUTION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS SENT TO THE BOARD FOR REVIEW BEFORE BEING FILED WITH THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS SHALL AVOID CONFLICT OF INTEREST IN MATTERS RELATED TO THEIR RESPONSIBILITIES AND DUTIES AS A MEMBER OF THE BOARD AND SHALL SEEK TO FAITHFULLY REFLECT IN THEIR ACTIONS AS TRUSTEE, PRACTICES WHICH INSURE THE BEST INTEREST OF THE CORPORATION, THE CLIENTS IT SERVES AND THE GENERAL PUBLIC. BOARD MEMBERS SHALL, ON AN ANNUAL BASIS, BE REQUIRED TO REAFFIRM THEIR UNDERSTANDING OF AND COMMITMENT TO AVOIDING CONFLICT OF INTEREST IN THEIR CAPACITY AS A MEMBER OF THE ALTA CARE GROUP BOARD OF DIRECTORS BY COMPLETING THE BOARD OF DIRECTORS CONFIDENTIALITY AND CONFLICT OF INTEREST AGREEMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHIEF EXECUTIVE OFFICER IS EVALUATED BY ALL MEMBERS OF THE GOVERNING BOARD ANNUALLY AND COMPENSATION IS DETERMINED BASED ON THOSE EVALUATIONS AND REVIEW OF THE AGENCY'S CURRRENT FINANCIAL CONDITION AND HOW IT COMPARES TO PRIOR YEARS. WAGE COMPARABILITY DATA IS PROVIDED TO THE GOVERNING BOARD TO ASSIST IN THEIR DECISION MAKING.</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 TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE WERE NO CHANGES MADE FROM PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>