﻿<?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>2025-05-08T08:18:04-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>450250958</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Eide Bailly LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>4585 Coleman St Ste 200</AddressLine1Txt>
        <CityNm>Bismarck</CityNm>
        <StateAbbreviationCd>ND</StateAbbreviationCd>
        <ZIPCd>58503</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>860865357</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Northern Nevada HIV Outpatient Program</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>Education and Services</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>NORT</BusinessNameControlTxt>
      <PhoneNum>7757864673</PhoneNum>
      <USAddress>
        <AddressLine1Txt>580 W 5th Street</AddressLine1Txt>
        <CityNm>Reno</CityNm>
        <StateAbbreviationCd>NV</StateAbbreviationCd>
        <ZIPCd>89503</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Sharon Chamberlain</PersonNm>
      <PersonTitleTxt>Chief Executive Officer</PersonTitleTxt>
      <PhoneNum>7757864673</PhoneNum>
      <SignatureDt>2025-05-07</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Lisa Chaffee CPA</PreparerPersonNm>
      <PTIN>P00193453</PTIN>
      <PhoneNum>7012551091</PhoneNum>
      <PreparationDt>2025-03-28</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="10">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>Northern Nevada HOPES</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>Sharon Chamberlain</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>580 W 5th Street</AddressLine1Txt>
        <CityNm>Reno</CityNm>
        <StateAbbreviationCd>NV</StateAbbreviationCd>
        <ZIPCd>89503</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>70177871</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.nnhopes.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1997</FormationYr>
      <LegalDomicileStateCd>NV</LegalDomicileStateCd>
      <ActivityOrMissionDesc>We provide affordable, high-quality medical, behavioral health &amp; support services for all.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>16</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>16</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>328</TotalEmployeeCnt>
      <TotalVolunteersCnt>17</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>14046424</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>29721805</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>36961777</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>39880358</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>180861</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>564980</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>-5207</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>-263</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>51183855</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>70166880</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>5929490</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>744231</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>20050943</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>23274553</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>102376</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>98663</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>723309</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>27596992</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>31916375</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>53679801</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>56033822</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-2495946</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>14133058</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>57164207</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>58679016</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>17998248</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>5058731</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>39165959</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>53620285</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>Northern Nevada Hopes provides affordable, high-quality, medical, behavioral health, and support services for all. We are dedicated to building a healthier community by providing coordinated care and support for individuals and family wellness. Our community health center combines primary care, medical specialties, behavioral health and prevention with a team of experienced professionals who are committed to high quality care.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>50110374</ExpenseAmt>
      <GrantAmt>744231</GrantAmt>
      <RevenueAmt>39880358</RevenueAmt>
      <Desc>Northern Nevada HOPES is a not-for-profit community health center located in downtown Reno, Nevada, offering integrated medical, behavioral health, and supportive services to over 15,814 patients, the majority of which are low income. The list of services offered includes primary medical, ultrasound and x-ray, on-site lab, on-site pharmacy, chronic disease management, behavioral health including intensive outpatient therapy, substance use treatment including medication-assisted treatment for opioid addiction, psychiatry, case management, and housing assistance. This unique team-based care approach to healthcare reduces barriers by creating a one-stop shop for our patients. HOPES specializes in serving the medically underserved in our community and works with many stigmatized populations, including the LGBTQ community, drug users, sex workers, and people experiencing homelessness and poverty. HOPES accepts most commercial insurance plans as well as Medicare and Medicaid, and HOPES offers a sliding fee scale for those who qualify. HOPES welcomes patients wherever they are in life and provides them with safe and non-judgmental services to support their health and well-being. In the fiscal year ended 6/30/2024, HOPES completed 69,736 medical and behavioral health visits.</Desc>
      <TotalProgramServiceExpensesAmt>50110374</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">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentId="RetDoc1041200001">1</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="RetDoc1041200001">1</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentId="RetDoc1041200001">0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">1</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">1</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>69</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>328</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>16</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>16</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>
      <OwnWebsiteInd>X</OwnWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Sharon Chamberlain</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>7757864673</PhoneNum>
        <USAddress>
          <AddressLine1Txt>580 W 5th Street</AddressLine1Txt>
          <CityNm>Reno</CityNm>
          <StateAbbreviationCd>NV</StateAbbreviationCd>
          <ZIPCd>89503</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Doug Brewer</PersonNm>
        <TitleTxt>President</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Trudy Larson</PersonNm>
        <TitleTxt>Vice President</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.10</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Chris Bosse</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cliff Scheffel</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Scott Brenneke</PersonNm>
        <TitleTxt>Director (thru Dec)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tom Durante</PersonNm>
        <TitleTxt>Director (thru Aug)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Todd Felts</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Pat Gallimore</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Theresa Navarro</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Par Tolles</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AG Burnett</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jane Fox</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Heidi Loeb</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Amy McCombs</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Susan Fisher</PersonNm>
        <TitleTxt>Director (from Dec)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Katelyn Cantu</PersonNm>
        <TitleTxt>Director (from Dec)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maria Sandra Jimenez</PersonNm>
        <TitleTxt>Director (from Dec)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Karen Massey</PersonNm>
        <TitleTxt>Director (from Jun)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Sharon Chamberlain</PersonNm>
        <TitleTxt>Chief Executive Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>251960</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32991</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Debra L De Vay</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>171502</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19916</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kelly Duncan thru Jan</PersonNm>
        <TitleTxt>Chief Operations Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>178779</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21191</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Julie Gwin from Jan</PersonNm>
        <TitleTxt>Chief Operations Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>109964</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14522</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Alexander Brooks</PersonNm>
        <TitleTxt>Psychiatrist</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>324391</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>46705</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jennifer Edwards</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>230083</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33684</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Natalie Vogel</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
        <AverageHoursPerWeekRt>37.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>211947</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25787</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Aimee Harter</PersonNm>
        <TitleTxt>MD Family Medicine</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>192691</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23611</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Chelsea Travers</PersonNm>
        <TitleTxt>MD Family Medicine</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>174296</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15631</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1845613</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>234038</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>35</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Laboratory Corporation of America</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 12140</AddressLine1Txt>
            <CityNm>Burlington</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>272162140</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Blood and specimen draws and reads</ServicesDesc>
        <CompensationAmt>458140</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Stenson Tamaddon LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>111 W Monroe St 17th Floor</AddressLine1Txt>
            <CityNm>Phoenix</CityNm>
            <StateAbbreviationCd>AZ</StateAbbreviationCd>
            <ZIPCd>85003</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Employee retention credits forms prepare</ServicesDesc>
        <CompensationAmt>387893</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>N2Growth Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1150 First Ave Suite 501</AddressLine1Txt>
            <CityNm>King of Prussia</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19406</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Executive search firm</ServicesDesc>
        <CompensationAmt>172260</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ESI Security Services Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 13047</AddressLine1Txt>
            <CityNm>Reno</CityNm>
            <StateAbbreviationCd>NV</StateAbbreviationCd>
            <ZIPCd>89507</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>After hours security service</ServicesDesc>
        <CompensationAmt>154096</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>4</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>41000</FundraisingAmt>
      <RelatedOrganizationsAmt>5000</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>11927413</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>17748392</AllOtherContributionsAmt>
      <NoncashContributionsAmt>156288</NoncashContributionsAmt>
      <TotalContributionsAmt>29721805</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>39838096</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39838096</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>42262</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>42262</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>39880358</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>575708</TotalRevenueColumnAmt>
        <ExclusionAmt>575708</ExclusionAmt>
      </InvestmentIncomeGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>10728</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>-10728</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-10728</TotalRevenueColumnAmt>
        <ExclusionAmt>-10728</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>41000</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>263</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-263</TotalRevenueColumnAmt>
        <ExclusionAmt>-263</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>70166880</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39880358</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>564717</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>744231</TotalAmt>
        <ProgramServicesAmt>744231</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>754818</TotalAmt>
        <ProgramServicesAmt>133130</ProgramServicesAmt>
        <ManagementAndGeneralAmt>621688</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>17588884</TotalAmt>
        <ProgramServicesAmt>15293893</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1916466</ManagementAndGeneralAmt>
        <FundraisingAmt>378525</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>539016</TotalAmt>
        <ProgramServicesAmt>499674</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28081</ManagementAndGeneralAmt>
        <FundraisingAmt>11261</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2815883</TotalAmt>
        <ProgramServicesAmt>2439583</ProgramServicesAmt>
        <ManagementAndGeneralAmt>312279</ManagementAndGeneralAmt>
        <FundraisingAmt>64021</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1575952</TotalAmt>
        <ProgramServicesAmt>1387477</ProgramServicesAmt>
        <ManagementAndGeneralAmt>154362</ManagementAndGeneralAmt>
        <FundraisingAmt>34113</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>13800</TotalAmt>
        <ManagementAndGeneralAmt>13800</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>101090</TotalAmt>
        <ManagementAndGeneralAmt>101090</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>98663</TotalAmt>
        <FundraisingAmt>98663</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForServicesOtherGrp>
        <TotalAmt>1585485</TotalAmt>
        <ProgramServicesAmt>900075</ProgramServicesAmt>
        <ManagementAndGeneralAmt>685410</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>208952</TotalAmt>
        <ProgramServicesAmt>32613</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48413</ManagementAndGeneralAmt>
        <FundraisingAmt>127926</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>576499</TotalAmt>
        <ProgramServicesAmt>405513</ProgramServicesAmt>
        <ManagementAndGeneralAmt>170986</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>915861</TotalAmt>
        <ProgramServicesAmt>740722</ProgramServicesAmt>
        <ManagementAndGeneralAmt>175139</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>1306899</TotalAmt>
        <ProgramServicesAmt>1124798</ProgramServicesAmt>
        <ManagementAndGeneralAmt>182101</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>16502</TotalAmt>
        <ProgramServicesAmt>12093</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3399</ManagementAndGeneralAmt>
        <FundraisingAmt>1010</FundraisingAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>50641</TotalAmt>
        <ProgramServicesAmt>40476</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2375</ManagementAndGeneralAmt>
        <FundraisingAmt>7790</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>429975</TotalAmt>
        <ManagementAndGeneralAmt>429975</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1024035</TotalAmt>
        <ProgramServicesAmt>920600</ProgramServicesAmt>
        <ManagementAndGeneralAmt>103435</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>231745</TotalAmt>
        <ManagementAndGeneralAmt>231745</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Other Pharmaceuticals,</Desc>
        <TotalAmt>25441444</TotalAmt>
        <ProgramServicesAmt>25422636</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18808</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>13447</TotalAmt>
        <ProgramServicesAmt>12860</ProgramServicesAmt>
        <ManagementAndGeneralAmt>587</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>56033822</TotalAmt>
        <ProgramServicesAmt>50110374</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5200139</ManagementAndGeneralAmt>
        <FundraisingAmt>723309</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>3628658</BOYAmt>
        <EOYAmt>3917847</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>4112043</BOYAmt>
        <EOYAmt>810208</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>3898795</BOYAmt>
        <EOYAmt>4801009</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>24040000</BOYAmt>
        <EOYAmt>24040000</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>708660</BOYAmt>
        <EOYAmt>735661</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>256052</BOYAmt>
        <EOYAmt>366141</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>20059484</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3405082</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>14981044</BOYAmt>
        <EOYAmt>16654402</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>5123208</BOYAmt>
        <EOYAmt>5588847</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>18766</BOYAmt>
        <EOYAmt>18766</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>396981</BOYAmt>
        <EOYAmt>1746135</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>57164207</BOYAmt>
        <EOYAmt>58679016</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2388872</BOYAmt>
        <EOYAmt>3307705</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>25477</BOYAmt>
        <EOYAmt>5000</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>15541429</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>42470</BOYAmt>
        <EOYAmt>1746026</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>17998248</BOYAmt>
        <EOYAmt>5058731</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>34823175</BOYAmt>
        <EOYAmt>52595162</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>4342784</BOYAmt>
        <EOYAmt>1025123</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>39165959</BOYAmt>
        <EOYAmt>53620285</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>57164207</BOYAmt>
        <EOYAmt>58679016</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>14133058</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>321268</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>9447640</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12805865</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>33942454</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>14046424</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>29721805</CurrentTaxYearAmt>
        <TotalAmt>99964188</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>9447640</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12805865</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>33942454</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>14046424</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>29721805</CurrentTaxYearAmt>
        <TotalAmt>99964188</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>11026979</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>88937209</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>154582</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>49861</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5175</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>189744</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>575708</CurrentTaxYearAmt>
        <TotalAmt>975070</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <CurrentTaxYearMinus2YearsAmt>100452</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>100452</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>28626</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>80567</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>234251</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>343444</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>101383154</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>165813009</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.87720</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.94030</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part II, Line 10, Explanation of Other Income:</FormAndLineReferenceDesc>
        <ExplanationTxt>Miscellaneous revenue - 2019 Amount: $ 28,626. 2020 Amount: $ 80,567. 2021 Amount: $ 234,251.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </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>971909</OtherCostOrOtherBasisAmt>
        <BookValueAmt>971909</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>12587577</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>833036</DepreciationAmt>
        <BookValueAmt>11754541</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>632882</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>331103</DepreciationAmt>
        <BookValueAmt>301779</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>5281903</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2143781</DepreciationAmt>
        <BookValueAmt>3138122</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>585213</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>97162</DepreciationAmt>
        <BookValueAmt>488051</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>16654402</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Finance Lease liability</Desc>
        <Amt>28006</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Operating Lease Liability</Desc>
        <Amt>1718020</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>1746026</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>HOPES believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. HOPES would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041200001">
      <MailSolicitationsInd>X</MailSolicitationsInd>
      <EmailSolicitationsInd>X</EmailSolicitationsInd>
      <PhoneSolicitationsInd>X</PhoneSolicitationsInd>
      <InPersonSolicitationsInd>X</InPersonSolicitationsInd>
      <SolicitationOfNonGovtGrantsInd>X</SolicitationOfNonGovtGrantsInd>
      <SolicitationOfGovtGrantsInd>X</SolicitationOfGovtGrantsInd>
      <SpecialFundraisingEventsInd>X</SpecialFundraisingEventsInd>
      <AgrmtProfFundraisingActyInd>1</AgrmtProfFundraisingActyInd>
      <FundraiserActivityInfoGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>Nexus Direct LLC</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>780 Lynnhaven Pkwy Ste 400</AddressLine1Txt>
          <CityNm>Virginia Beach</CityNm>
          <StateAbbreviationCd>VA</StateAbbreviationCd>
          <ZIPCd>23452</ZIPCd>
        </USAddress>
        <ActivityTxt>See Sch G, part IV</ActivityTxt>
        <FundraiserControlOfFundsInd>0</FundraiserControlOfFundsInd>
        <GrossReceiptsAmt>39548</GrossReceiptsAmt>
        <RetainedByContractorAmt>98663</RetainedByContractorAmt>
        <NetToOrganizationAmt>39548</NetToOrganizationAmt>
      </FundraiserActivityInfoGrp>
      <TotalGrossReceiptsAmt>39548</TotalGrossReceiptsAmt>
      <TotalRetainedByContractorsAmt>98663</TotalRetainedByContractorsAmt>
      <TotalNetToOrganizationAmt>39548</TotalNetToOrganizationAmt>
      <LicensedStatesCd>CA</LicensedStatesCd>
      <LicensedStatesCd>NV</LicensedStatesCd>
      <LicensedStatesCd>CO</LicensedStatesCd>
      <LicensedStatesCd>VA</LicensedStatesCd>
      <LicensedStatesCd>CT</LicensedStatesCd>
      <LicensedStatesCd>AZ</LicensedStatesCd>
      <LicensedStatesCd>ID</LicensedStatesCd>
      <LicensedStatesCd>IA</LicensedStatesCd>
      <LicensedStatesCd>LA</LicensedStatesCd>
      <LicensedStatesCd>MO</LicensedStatesCd>
      <LicensedStatesCd>OH</LicensedStatesCd>
      <LicensedStatesCd>TX</LicensedStatesCd>
      <LicensedStatesCd>WV</LicensedStatesCd>
      <LicensedStatesCd>WY</LicensedStatesCd>
      <FundraisingEventInformationGrp>
        <Event1Nm>Lisa Mead Book Signing</Event1Nm>
        <GrossReceiptsEvent1Amt>41000</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>41000</CharitableContriEvent1Amt>
        <RentFacilityCostsEvent1Amt>263</RentFacilityCostsEvent1Amt>
        <GrossReceiptsTotalAmt>41000</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>41000</CharitableContributionsTotAmt>
        <RentFcltyCostsTotalEventsAmt>263</RentFcltyCostsTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>263</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-263</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule G, Part I, line 2, column (ii):</FormAndLineReferenceDesc>
        <ExplanationTxt>Activity includes creation of a direct mail program in order for HOPES to solicit donors, as well as rental of lists.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleG>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Transportation Assistance</GrantTypeTxt>
        <RecipientCnt>1358</RecipientCnt>
        <NonCashAssistanceAmt>152426</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Esimated Value</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Uber, Bus Passes, Taxis, Gas vouchers</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Housing</GrantTypeTxt>
        <RecipientCnt>91</RecipientCnt>
        <CashGrantAmt>331748</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Household Items/Misc Assistance</GrantTypeTxt>
        <RecipientCnt>5948</RecipientCnt>
        <NonCashAssistanceAmt>139728</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Esimated Value</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Household items, Storage, Clothing, and Laundry</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Food</GrantTypeTxt>
        <RecipientCnt>143</RecipientCnt>
        <NonCashAssistanceAmt>33151</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Esimated Value</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Food Pantry</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Rx Co-Pay</GrantTypeTxt>
        <RecipientCnt>739</RecipientCnt>
        <NonCashAssistanceAmt>87178</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Amount Paid</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Payment for RX prescriptions</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Payments are made directly to the Landlord, utility, creditor, etc. Food passes and bus passes are given in lieu of cash to ensure they're used for appropriate purposes.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <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>Alexander Brooks</PersonNm>
        <TitleTxt>Psychiatrist</TitleTxt>
        <BaseCompensationFilingOrgAmt>324391</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13618</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>33087</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>371096</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sharon Chamberlain</PersonNm>
        <TitleTxt>Chief Executive Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>206960</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>45000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10195</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22796</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>284951</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jennifer Edwards</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>230083</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9668</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24016</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>263767</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Natalie Vogel</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>211947</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8670</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>17117</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>237734</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Aimee Harter</PersonNm>
        <TitleTxt>MD Family Medicine</TitleTxt>
        <BaseCompensationFilingOrgAmt>192691</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7979</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15632</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>216302</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kelly Duncan thru Jan</PersonNm>
        <TitleTxt>Chief Operations Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>178779</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7343</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13848</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>199970</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Debra L De Vay</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>171502</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6985</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12931</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>191418</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Chelsea Travers</PersonNm>
        <TitleTxt>MD Family Medicine</TitleTxt>
        <BaseCompensationFilingOrgAmt>174296</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5386</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10245</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>189927</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>HOPES reimburses every employee who submits a request $10 every month for fitness costs.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <WorksOfArtGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>18</ContributionCnt>
        <NoncashContributionsRptF990Amt>93486</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Professional Appraiser</MethodOfDeterminingRevenuesTxt>
      </WorksOfArtGrp>
      <ClothingAndHouseholdGoodsGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <NoncashContributionsRptF990Amt>16390</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Replacement cost.</MethodOfDeterminingRevenuesTxt>
      </ClothingAndHouseholdGoodsGrp>
      <SecuritiesPubliclyTradedGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>26</ContributionCnt>
        <NoncashContributionsRptF990Amt>5024</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Value at time of sale</MethodOfDeterminingRevenuesTxt>
      </SecuritiesPubliclyTradedGrp>
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>2</ContributionCnt>
        <NoncashContributionsRptF990Amt>37988</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Replacement cost.</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>Autoclave</Desc>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>3399</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Replacement cost</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>1</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Column (b):</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule M, Part I, lines 1 and 9, Column (b) reports items contributed. Schedule M, Part I, lines 20, and 25, Column (b) reports number of contributions.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is provided to the Finance Committee, who reviews it and recommends to send it to the Board for approval. It is then provided to the Board, who then approves it at the next Board meeting.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The conflict of interest policy covers employees, Board members, volunteers, and contractors. Each person must fill out a conflict of interest form in which any possible conflicts of interest are disclosed. Board members are not allowed to vote on any issue that might involve a conflict of interest. The Director of HR and the CEO review the forms to determine conflicts of interest. Noncompliance with the policy are reported to the supervisor, and if necessary, to the CEO or Risk Manager.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board sets and approves the compensation for the CEO. They may ask the HR Director for comparable market data to make this determination. The compensation of the other Officers of the organization is set by the CEO. She will ask the HR Director for comparable market data to make the determination. Personnel Action Forms are prepared by the HR Director for any changes in compensation, and are reviewed and signed by the CFO and the CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The audit is made available on the Federal Clearing House site, as well as by request. All other documents are provided upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NNH QALICB</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>580 West 5th Street</AddressLine1Txt>
          <CityNm>Reno</CityNm>
          <StateAbbreviationCd>NV</StateAbbreviationCd>
          <ZIPCd>89503</ZIPCd>
        </USAddress>
        <EIN>473098270</EIN>
        <PrimaryActivitiesTxt>Support Northern Nevada HOPES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Northern Nevada HOPES</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NNH Support</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>580 West 5th Street</AddressLine1Txt>
          <CityNm>Reno</CityNm>
          <StateAbbreviationCd>NV</StateAbbreviationCd>
          <ZIPCd>89503</ZIPCd>
        </USAddress>
        <EIN>473106111</EIN>
        <PrimaryActivitiesTxt>Support Northern Nevada HOPES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Northern Nevada HOPES</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>1</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>1</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NNH QALICB</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>80148</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>GL</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>