﻿<?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="2024v5.5">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2026-02-18T08:43:38-06:00</ReturnTs>
    <TaxPeriodEndDt>2025-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>341667340</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>PACKER THOMAS</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>6601 WESTFORD PLACE SUITE 101</AddressLine1Txt>
        <CityNm>CANFIELD</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44406</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>341417161</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>COLUMBIANA COUNTY MENTAL HEALTH</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>CLINIC</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>COLU</BusinessNameControlTxt>
      <PhoneNum>3304247761</PhoneNum>
      <USAddress>
        <AddressLine1Txt>PO BOX 429 40722 STATE ROUTE 154</AddressLine1Txt>
        <CityNm>LISBON</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>444320429</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>ROGER SIKORSZKY</PersonNm>
      <PersonTitleTxt>EXECUTIVE DIRECTOR</PersonTitleTxt>
      <PhoneNum>3304247761</PhoneNum>
      <SignatureDt>2026-02-10</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>RICHARD A SCHAFER CPA</PreparerPersonNm>
      <PTIN>P00390129</PTIN>
      <PhoneNum>3305339777</PhoneNum>
      <PreparationDt>2026-01-26</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>ROGER SIKORSZKY</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>PO BOX 429 40722 STATE ROUTE 154</AddressLine1Txt>
        <CityNm>LISBON</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>444320429</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>10466071</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>N/A</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1963</FormationYr>
      <LegalDomicileStateCd>OH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>THE MISSION OF THE COLUMBIANA COUNTY MENTAL HEALTH CLINIC IS TO IMPROVE THE LIVES OF INDIVIDUALS AND FAMILIES BY MEETING THE BEHAVIORAL HEALTH NEEDS OF OUR COMMUNITY. THIS IS ACCOMPLISHED THROUGH: 1) EXCELLENT CUSTOMER SERVICE, 2) EVIDENCE-BASED PRACTICE, 3) CONTINUOUS PERFORMANCE IMPROVEMENT, AND 4) RECOVERY-FOCUSED CARE THAT IS COMPREHENSIVE, EFFECTIVE, AND AFFORDABLE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>11</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>173</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>11620</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>17504</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>9578029</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>10007745</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>49408</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>54692</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>273347</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>386130</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>9912404</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>10466071</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>7818966</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>8142227</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>2325777</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>2405539</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>10144743</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>10547766</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-232339</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-81695</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>9393533</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>10089592</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>2462822</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>3117909</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>6930711</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>6971683</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>THE MISSION OF THE COLUMBIANA COUNTY MENTAL HEALTH CLINIC IS TO IMPROVE THE LIVES OF INDIVIDUALS AND FAMILIES BY MEETING THE BEHAVIORAL HEALTH NEEDS OF OUR COMMUNITY. THIS IS ACCOMPLISHED THROUGH: 1) EXCELLENT CUSTOMER SERVICE, 2) EVIDENCE-BASED PRACTICE, 3) CONTINUOUS PERFORMANCE IMPROVEMENT, AND 4) RECOVERY-FOCUSED CARE THAT IS COMPREHENSIVE, EFFECTIVE, AND AFFORDABLE.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>9732419</ExpenseAmt>
      <RevenueAmt>10393875</RevenueAmt>
      <Desc>TO PROVIDE COUNSELING, TREATMENT, EDUCATION, PREVENTION, THERAPY, AND OTHER ANCILLARY SERVICES FOR INDIVIDUALS AND FAMILIES WITH EMOTIONAL AND SUBSTANCE ABUSE PROBLEMS.</Desc>
      <TotalProgramServiceExpensesAmt>9732419</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</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">0</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>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043500001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043500001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043500001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043500001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>72</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>173</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <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>11</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</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>
      <StatesWhereCopyOfReturnIsFldCd>OH</StatesWhereCopyOfReturnIsFldCd>
      <OtherWebsiteInd>X</OtherWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>BETH TODD</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>3304249573</PhoneNum>
        <USAddress>
          <AddressLine1Txt>PO BOX 429 40722 STATE ROUTE 154</AddressLine1Txt>
          <CityNm>LISBON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44432</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH SIEFKE</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL T MOORE</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SARA MAINWARING</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>REV LEO WEHRLIN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERRY MCELROY</PersonNm>
        <TitleTxt>SECRETARY/TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY T BRICKER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GINA DERMOTTA</PersonNm>
        <TitleTxt>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>TISHA HAUSTMAN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EUGENE GALLO</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AUSTIN FREDRICKSON</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW WERNER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROGER SIKORSZKY</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>136471</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3311</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BETH TODD</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>86070</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11164</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SETH B FRAMPTON</PersonNm>
        <TitleTxt>DIRECTOR OF PSYCHIATRIC DEPT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>195303</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31006</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ASHLEIGH NOEL</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>185780</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3144</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINDA S BOYLE</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>158351</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8683</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>761975</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>57308</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>4</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JONES BROTHERS SERVICE SPECIALTIES LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>49924 STATE ROUTE 154</AddressLine1Txt>
            <CityNm>NEGLEY</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44441</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>REPAIRS AND MAINTENANCE SERVICES</ServicesDesc>
        <CompensationAmt>406471</CompensationAmt>
      </ContractorCompensationGrp>
      <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>STAFFING AGENCY</ServicesDesc>
        <CompensationAmt>175292</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>2</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>17504</AllOtherContributionsAmt>
      <TotalContributionsAmt>17504</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>FEES &amp; CONTRACTS</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>8560207</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8560207</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACTS</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>630927</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>630927</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>INSURANCE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>422733</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>422733</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE PAYMENTS</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>231787</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>231787</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SELF PAY PATIENT FEES</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>125811</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>125811</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>36280</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>36280</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>10007745</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>54692</TotalRevenueColumnAmt>
        <ExclusionAmt>54692</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>234993</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>234993</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>FORGIVENESS OF DEBT</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>119451</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>119451</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>PAYEESHIP FEES</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>31686</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>31686</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>386130</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>10466071</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10393875</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>54692</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>463324</TotalAmt>
        <ManagementAndGeneralAmt>463324</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6051649</TotalAmt>
        <ProgramServicesAmt>5929955</ProgramServicesAmt>
        <ManagementAndGeneralAmt>121694</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1139354</TotalAmt>
        <ProgramServicesAmt>1125930</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13424</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>487900</TotalAmt>
        <ProgramServicesAmt>445335</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42565</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>57182</TotalAmt>
        <ManagementAndGeneralAmt>57182</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>11700</TotalAmt>
        <ManagementAndGeneralAmt>11700</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>17401</TotalAmt>
        <ManagementAndGeneralAmt>17401</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>230758</TotalAmt>
        <ProgramServicesAmt>230758</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>7431</TotalAmt>
        <ProgramServicesAmt>7138</ProgramServicesAmt>
        <ManagementAndGeneralAmt>293</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>77510</TotalAmt>
        <ProgramServicesAmt>64140</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13370</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>62583</TotalAmt>
        <ProgramServicesAmt>59183</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3400</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>493478</TotalAmt>
        <ProgramServicesAmt>491755</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1723</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>207538</TotalAmt>
        <ProgramServicesAmt>207509</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>7880</TotalAmt>
        <ProgramServicesAmt>7429</ProgramServicesAmt>
        <ManagementAndGeneralAmt>451</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>13444</TotalAmt>
        <ProgramServicesAmt>13444</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>270825</TotalAmt>
        <ProgramServicesAmt>270825</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>84886</TotalAmt>
        <ProgramServicesAmt>80551</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4335</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>HOUSING PROGRAM EXPENSE</Desc>
        <TotalAmt>360513</TotalAmt>
        <ProgramServicesAmt>360513</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES</Desc>
        <TotalAmt>243199</TotalAmt>
        <ProgramServicesAmt>209768</ProgramServicesAmt>
        <ManagementAndGeneralAmt>33431</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER PROGRAM EXPENSES</Desc>
        <TotalAmt>161542</TotalAmt>
        <ProgramServicesAmt>158696</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2846</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EQUIPMENT RENTAL</Desc>
        <TotalAmt>31900</TotalAmt>
        <ProgramServicesAmt>27912</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3988</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>65769</TotalAmt>
        <ProgramServicesAmt>41578</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24191</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>10547766</TotalAmt>
        <ProgramServicesAmt>9732419</ProgramServicesAmt>
        <ManagementAndGeneralAmt>815347</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1917418</BOYAmt>
        <EOYAmt>1360366</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1555879</BOYAmt>
        <EOYAmt>1465608</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>56730</BOYAmt>
        <EOYAmt>166232</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>8502822</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4175372</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>4102119</BOYAmt>
        <EOYAmt>4327450</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>1741053</BOYAmt>
        <EOYAmt>1892127</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>20334</BOYAmt>
        <EOYAmt>877809</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>9393533</BOYAmt>
        <EOYAmt>10089592</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>144800</BOYAmt>
        <EOYAmt>1129027</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>1302134</BOYAmt>
        <EOYAmt>1679413</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>1015888</BOYAmt>
        <EOYAmt>309469</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>2462822</BOYAmt>
        <EOYAmt>3117909</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>6930460</BOYAmt>
        <EOYAmt>6970876</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>251</BOYAmt>
        <EOYAmt>807</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>6930711</BOYAmt>
        <EOYAmt>6971683</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>9393533</BOYAmt>
        <EOYAmt>10089592</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-81695</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>122667</NetUnrlzdGainsLossesInvstAmt>
      <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">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>9632</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9054</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>13933</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11620</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>17504</CurrentTaxYearAmt>
        <TotalAmt>61743</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>8675222</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9306638</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9800979</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9578029</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10007745</CurrentTaxYearAmt>
        <TotalAmt>47368613</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>8684854</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9315692</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9814912</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9589649</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10025249</CurrentTaxYearAmt>
        <TotalAmt>47430356</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>47430356</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>38801</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>35709</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>44108</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>49408</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>54692</CurrentTaxYearAmt>
        <TotalAmt>222718</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>38801</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>35709</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>44108</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>49408</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>54692</CurrentTaxYearAmt>
        <TotalAmt>222718</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>1350148</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>213721</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>240948</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>273347</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>386130</CurrentTaxYearAmt>
        <TotalAmt>2464294</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>10073803</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9565122</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10099968</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9912404</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10466071</CurrentTaxYearAmt>
        <TotalAmt>50117368</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.94640</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.94700</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00440</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00420</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MISCELLANEOUS INCOME - 2020 AMOUNT: $ 1,350,148. 2021 AMOUNT: $ 213,721. 2022 AMOUNT: $ 240,948. 2023 AMOUNT: $ 273,347. 2024 AMOUNT: $ 386,130.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>304730</OtherCostOrOtherBasisAmt>
        <BookValueAmt>304730</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>7372929</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3539328</DepreciationAmt>
        <BookValueAmt>3833601</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>825163</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>636044</DepreciationAmt>
        <BookValueAmt>189119</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>4327450</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>OPERATING LEASE - RIGHT OF USE ASSETS</Desc>
        <BookValueAmt>6268</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>CONSTRUCTION IN PROCESS</Desc>
        <BookValueAmt>871541</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>877809</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>SECURITY DEPOSITS</Desc>
        <Amt>12875</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>PARTICIPANT DEPOSITS</Desc>
        <Amt>152414</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OBLIGATIONS UNDER OPERATING LEASES</Desc>
        <Amt>6229</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>CONDITIONAL CONTRIBUTIONS</Desc>
        <Amt>11470</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER ACCRUED EXPENSES</Desc>
        <Amt>126481</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>309469</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>10571337</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>122667</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>-17401</OtherRevenueAmt>
      <RevenueNotReportedAmt>105266</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>10466071</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>10466071</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>10530365</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>10530365</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>17401</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>17401</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>10547766</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>INVESTMENT FEES -17,401.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>INVESTMENT FEES 17,401.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <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>SETH B FRAMPTON</PersonNm>
        <TitleTxt>DIRECTOR OF PSYCHIATRIC DEPT</TitleTxt>
        <BaseCompensationFilingOrgAmt>195303</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>31006</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>226309</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ASHLEIGH NOEL</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>185780</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3144</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>188924</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LINDA S BOYLE</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>158351</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8683</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>167034</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF TRUSTEES HAS DELEGATED OVERALL RESPONSIBILITY FOR THE CORPORATE COMPLIANCE PROGRAM TO THE EXECUTIVE DIRECTOR, WHO IN TURN DESIGNATES THE QUALITY IMPROVEMENT CHAIRPERSON AS THE CORPORATE COMPLIANCE OFFICER TO MONITOR THE ORGANIZATION'S CORPORATE COMPLIANCE PROGRAM AND PROVIDE PERIODIC AND REGULAR REPORTS TO THE BOARD OF TRUSTEES ON MATTERS PERTAINING TO THE PROGRAM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCE AND EXECUTIVE COMMITTEES COMPLETE AN ANNUAL PERFORMANCE REVIEW. THEY REVIEW COMPENSATION COMPARED TO OHIO COUNCIL SALARY SURVEYS FOR SIMILAR ORGANIZATIONS IN OHIO. THE EXECUTIVE DIRECTOR SETS COMPENSATION OF ANY KEY EMPLOYEES WITH REVIEW BY BOARD OF FINANCE AND/OR EXECUTIVE COMMITTEE UTILIZING THE OHIO COUNCIL SALARY SURVEY OF COMPARABLE ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE 990 RETURN IS MADE AVAILABLE UPON REQUEST OR THROUGH GUIDESTAR WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>NO CHANGE FROM PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043500001">
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>COLUMBIANA COUNTY MENTAL HEALTH ENTERPRISES</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>40722 STATE ROUTE 154</AddressLine1Txt>
          <CityNm>LISBON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44432</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>INACTIVE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>COLUMBIANA COUNTY MENTAL HEALTH CLINIC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>S</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>