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      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <GovernmentGrantsAmt>1635419</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>34027</AllOtherContributionsAmt>
      <TotalContributionsAmt>1669446</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Fees for Medical Services</Desc>
        <BusinessCd>621111</BusinessCd>
        <TotalRevenueColumnAmt>4076530</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Partnership Income</Desc>
        <BusinessCd>621111</BusinessCd>
        <TotalRevenueColumnAmt>1261886</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>5338416</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>75603</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>75603</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>1300</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>1300</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>1300</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1300</RelatedOrExemptFuncIncomeAmt>
      </NetRentalIncomeOrLossGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>7084765</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5339716</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>75603</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>633159</TotalAmt>
        <ProgramServicesAmt>377003</ProgramServicesAmt>
        <ManagementAndGeneralAmt>254271</ManagementAndGeneralAmt>
        <FundraisingAmt>1885</FundraisingAmt>
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      <OtherSalariesAndWagesGrp>
        <TotalAmt>3612238</TotalAmt>
        <ProgramServicesAmt>3362432</ProgramServicesAmt>
        <ManagementAndGeneralAmt>239474</ManagementAndGeneralAmt>
        <FundraisingAmt>10332</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>632376</TotalAmt>
        <ProgramServicesAmt>557010</ProgramServicesAmt>
        <ManagementAndGeneralAmt>73546</ManagementAndGeneralAmt>
        <FundraisingAmt>1820</FundraisingAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>291751</TotalAmt>
        <ProgramServicesAmt>256980</ProgramServicesAmt>
        <ManagementAndGeneralAmt>33931</ManagementAndGeneralAmt>
        <FundraisingAmt>840</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>47983</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForServicesOtherGrp>
        <TotalAmt>76644</TotalAmt>
        <ProgramServicesAmt>70551</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5946</ManagementAndGeneralAmt>
        <FundraisingAmt>147</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>29098</TotalAmt>
        <ProgramServicesAmt>25007</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3122</ManagementAndGeneralAmt>
        <FundraisingAmt>969</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>145292</TotalAmt>
        <ProgramServicesAmt>127396</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17751</ManagementAndGeneralAmt>
        <FundraisingAmt>145</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>215222</TotalAmt>
        <ProgramServicesAmt>215222</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>308317</ProgramServicesAmt>
        <ManagementAndGeneralAmt>40710</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>12029</TotalAmt>
        <ProgramServicesAmt>10595</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1399</ManagementAndGeneralAmt>
        <FundraisingAmt>35</FundraisingAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>204250</TotalAmt>
        <ProgramServicesAmt>204250</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>40016</TotalAmt>
        <ProgramServicesAmt>29704</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10276</ManagementAndGeneralAmt>
        <FundraisingAmt>36</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>220441</TotalAmt>
        <ProgramServicesAmt>220441</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Service Agreements</Desc>
        <TotalAmt>119421</TotalAmt>
        <ProgramServicesAmt>119421</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Dues &amp; Subscriptions</Desc>
        <TotalAmt>26203</TotalAmt>
        <ProgramServicesAmt>23147</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3056</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Contract Pharmacy Expenses</Desc>
        <TotalAmt>410462</TotalAmt>
        <ProgramServicesAmt>410462</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>6062</TotalAmt>
        <ProgramServicesAmt>6062</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>7071674</TotalAmt>
        <ProgramServicesAmt>6324000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>731465</ManagementAndGeneralAmt>
        <FundraisingAmt>16209</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2632758</BOYAmt>
        <EOYAmt>2352417</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <EOYAmt>261161</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
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        <EOYAmt>469514</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>86453</BOYAmt>
        <EOYAmt>49463</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>3010083</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1087041</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1951348</BOYAmt>
        <EOYAmt>1923042</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsProgramRelatedGrp>
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        <EOYAmt>380818</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>532522</BOYAmt>
        <EOYAmt>463624</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>5900039</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>551965</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>68473</BOYAmt>
        <EOYAmt>41278</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>571177</BOYAmt>
        <EOYAmt>503196</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>13136</BOYAmt>
        <EOYAmt>9751</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>1124331</BOYAmt>
        <EOYAmt>1106190</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>4446654</BOYAmt>
        <EOYAmt>4445949</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>354120</BOYAmt>
        <EOYAmt>347900</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>4800774</BOYAmt>
        <EOYAmt>4793849</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>5925105</BOYAmt>
        <EOYAmt>5900039</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>13091</ReconcilationRevenueExpnssAmt>
      <PriorPeriodAdjustmentsAmt>-20016</PriorPeriodAdjustmentsAmt>
      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA-01" softwareId="24020153">
      <HospitalInd>X</HospitalInd>
      <OtherSupportSumAmt>0</OtherSupportSumAmt>
      <PublicSupportCY170Pct>0</PublicSupportCY170Pct>
      <PublicSupportTotal509Amt>0</PublicSupportTotal509Amt>
      <PublicSupportCY509Pct>0</PublicSupportCY509Pct>
      <InvestmentIncomeCYPct>0</InvestmentIncomeCYPct>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB-01">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD-01" softwareId="24020153">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>241100</OtherCostOrOtherBasisAmt>
        <BookValueAmt>241100</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>248800</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>143060</DepreciationAmt>
        <BookValueAmt>105740</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1897618</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>523757</DepreciationAmt>
        <BookValueAmt>1373861</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>622565</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>420224</DepreciationAmt>
        <BookValueAmt>202341</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>1923042</TotalBookValueLandBuildingsAmt>
      <InvstProgramRelatedOrgGrp>
        <Desc>Investment in MCHS, LLLP</Desc>
        <BookValueAmt>380818</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </InvstProgramRelatedOrgGrp>
      <TotalBookValueProgramRltdAmt>380818</TotalBookValueProgramRltdAmt>
      <OtherAssetsOrgGrp>
        <Desc>security deposit</Desc>
        <BookValueAmt>5100</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Lease Right of Use Asset</Desc>
        <BookValueAmt>458524</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>463624</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Post Retirement Benefit Liab</Desc>
        <Amt>9751</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>9751</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>7084765</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>7084765</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>7084765</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>7071674</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>7071674</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>7071674</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization follows the guidance of the Financial Accounting Standards Board Accounting Standards Codification 740-10, Accounting for Uncertainty in Income Taxes which clarifies the accounting for the recognition and measurement of the benefits of individual tax positions in the financial statements, including those of non-profit organizations. Tax positions must meet a recognition threshold of more-likely-than-not in order for the benefit of those tax positions to be recognized in the financial statements. The Organization analyzes tax positions taken, including those related to the requirements set forth in IRC Section 501(c) to qualify as a tax exempt organization, activities performed by volunteers and board members, the reporting of unrelated business income, and its status as a tax-exempt organization under Maryland statute. The Organization does not know of any tax benefits arising from uncertain tax positions and there was no effect on the Organizations financial position or changes in net assets as a result of analyzing its tax positions.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XI, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Loss on disposal of asset</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ-01">
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Juanita Tryon</PersonNm>
        <BaseCompensationFilingOrgAmt>174089</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13921</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>188010</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="24020153">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors reviews and evaluates the Chief Executive Officer to determine compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Chief Executive Officer reviews and evaluates all of the employees to determine compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All governing documents, financial statements etc. are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Prior to filing with the IRS, Form 990 is presented to the members of the finance committee of the board of directors for review. Form 990 is then disseminated to the entire board, the finance committee recommends to the board whether or not to accept the return, discussion ensues, as needed, and the board votes to file the return as presented or recommends changes. If changes are recommended, the process is repeated.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>