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        <ProgramServicesAmt>603157</ProgramServicesAmt>
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        <ProgramServicesAmt>14933</ProgramServicesAmt>
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      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>6250</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10303</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>159</ProgramServicesAmt>
        <ManagementAndGeneralAmt>121</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>213623</ProgramServicesAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>102528</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>PHARMACEUTICALS</Desc>
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        <ProgramServicesAmt>4593956</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>1482786</ProgramServicesAmt>
        <ManagementAndGeneralAmt>448785</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>359780</ProgramServicesAmt>
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      <OtherExpensesGrp>
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      <AllOtherExpensesGrp>
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        <ProgramServicesAmt>468954</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>31652945</ProgramServicesAmt>
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        <EOYAmt>3169475</EOYAmt>
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        <EOYAmt>464374</EOYAmt>
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        <EOYAmt>2753647</EOYAmt>
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        <EOYAmt>189381</EOYAmt>
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        <EOYAmt>11352597</EOYAmt>
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        <EOYAmt>2028558</EOYAmt>
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        <EOYAmt>6103179</EOYAmt>
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        <EOYAmt>26617463</EOYAmt>
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        <EOYAmt>4263081</EOYAmt>
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        <EOYAmt>6198442</EOYAmt>
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        <EOYAmt>12698869</EOYAmt>
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        <EOYAmt>13918594</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>26617463</EOYAmt>
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      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
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    <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>
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        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>1</DirectContactLegislatorsInd>
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      <OtherActivitiesInd>0</OtherActivitiesInd>
      <TotalLobbyingExpendituresAmt>34953</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PAID MEMBERSHIP DUES TO COMMUNITY HEALTH CARE ASSOCIATION OF NEW YORK STATE TO SUPPORT ITS MISSION OF ADVOCATING FOR THE HEALTH CENTERS NEEDS.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <BookValueAmt>16000</BookValueAmt>
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      <BuildingsGrp>
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      <OtherLiabilitiesOrgGrp>
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      <OtherLiabilitiesOrgGrp>
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      <OtherLiabilitiesOrgGrp>
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      <FootnoteTextInd>X</FootnoteTextInd>
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      <NetUnrealizedGainsInvstAmt>1067</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>1067</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>32641665</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>7993</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>-36635</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-28642</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>32613023</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>36086710</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>36635</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>36635</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>36050075</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>7993</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>7993</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>36058068</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2024 AND 2023, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2021 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS.</ExplanationTxt>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>FUNDRAISING EVENT EXPENSES 36,635.</ExplanationTxt>
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        <GrossRevenueEvent1Amt>7600</GrossRevenueEvent1Amt>
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        <CharitableContributionsTotAmt>55400</CharitableContributionsTotAmt>
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        <RentFcltyCostsTotalEventsAmt>24334</RentFcltyCostsTotalEventsAmt>
        <EntertainmentTotalEventsAmt>4799</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>5049</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>36635</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-29035</NetIncomeSummaryAmt>
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    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
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      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
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      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
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      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TRICIA PETER-CLARK</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PATRICK CARGUELLO</PersonNm>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MELISSA NOEL</PersonNm>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>314680</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MEGAN PECHA</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7950</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>33017</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>312964</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS HANNA</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SCOTT C VAN GORDER</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>290691</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARIE DESRAVINES</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>262756</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7980</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>11463</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>282199</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GLENN F THIBAULT</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>266250</BaseCompensationFilingOrgAmt>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TRACY WIMMER</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>204270</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6412</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>33017</NontaxableBenefitsFilingOrgAmt>
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        <TotalCompensationFilingOrgAmt>243699</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>INCLUDED ON SCHEDULE J, PART II, COLUMN B(II) ARE AMOUNTS REPRESENTING BONUS PAYMENTS. THESE AMOUNTS WERE APPROVED BY THE BOARD AND INCLUDED IN THE INDIVIDUAL'S W-2'S.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>OSWEGO COUNTY CIVIC FACILITIES CORPORATION</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>275217344</BondIssuerEIN>
        <BondIssuedDt>2024-07-25</BondIssuedDt>
        <IssuePriceAmt>6794635</IssuePriceAmt>
        <PurposeDesc>RENOVATION AND RECONSTRUCTION FOR THE HEALTH CENTER</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>2554743</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>317397</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>373130</OtherSpentProceedsAmt>
        <UnspentAmt>6104108</UnspentAmt>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>0</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, BOND ISSUED AMOUNT:</FormAndLineReferenceDesc>
        <ExplanationTxt>ON JULY 25, 2024, THE CENTER CLOSED WITH OSWEGO COUNTY CIVIC FACILITIES CORPORATION ISSUING TAX EXEMPT REVENUE BONDS, SERIES 2021 OF UP TO $6,794,635. AS OF DECEMBER 31, 2024 AMOUNT ISSUED WAS $2,554,743.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, ITEM C</FormAndLineReferenceDesc>
        <ExplanationTxt>DBA: CONNEXTCARE DBA: CONNEXTCARE</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990 IS REVIEWED BY THE CEO, CFO AND FINANCE COMMITTEE. ONCE APPROVAL HAS BEEN RECEIVED, A COPY IS PROVIDED TO THE FULL BOARD OF DIRECTORS PRIOR TO BEING FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE OF THE POLICY THROUGH THE QUALITY COMMITTEE. AFTER THE ANNUAL REVIEW OF THE CONFLICT OF INTEREST POLICY BY THE QUALITY COMMITTEE, OFFICERS, DIRECTORS, BOARD MEMBERS, AND KEY EMPLOYEES ARE REQUIRED TO SIGN-OFF. NEW STAFF AND BOARD MEMBERS ARE REQUIRED TO READ AND SIGN OFF THAT THEY UNDERSTAND THE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION FOR THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS, USING HEALTHCARE INDUSTRY STANDARDS, AND IS REFLECTED CONTRACTUALLY. THE BOARD THEN VOTES TO APPROVE THE CEO'S COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST ONLY.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>