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        <BOYAmt>300433</BOYAmt>
        <EOYAmt>655060</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
        <BOYAmt>2111859</BOYAmt>
        <EOYAmt>2144708</EOYAmt>
      </PermanentlyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>10744065</BOYAmt>
        <EOYAmt>12859179</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>11431037</BOYAmt>
        <EOYAmt>13367779</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>880156</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>1234958</NetUnrlzdGainsLossesInvstAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="00000002" softwareId="13000178">
      <SupportingOrganization509a3Ind>X</SupportingOrganization509a3Ind>
      <SupportingOrgType3FuncIntInd>X</SupportingOrgType3FuncIntInd>
      <ContributionControllerInd>false</ContributionControllerInd>
      <ContributionFamilyInd>false</ContributionFamilyInd>
      <Contribution35ControlledInd>false</Contribution35ControlledInd>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1>WCA HOSPITAL</BusinessNameLine1>
        </SupportedOrganizationName>
        <EIN>160743226</EIN>
        <OrganizationTypeDesc>HOSPITAL</OrganizationTypeDesc>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportedOrgNotifiedInd>true</SupportedOrgNotifiedInd>
        <USOrganizedInd>true</USOrganizedInd>
        <SupportAmt>350353</SupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrganizationsTotalCnt>1</SupportedOrganizationsTotalCnt>
      <SupportSumAmt>350353</SupportSumAmt>
      <PublicSupportTotal170Amt>0</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <TotalAmt>0</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <PublicSupportCY170Pct>0</PublicSupportCY170Pct>
      <PublicSupportTotal509Amt>0</PublicSupportTotal509Amt>
      <PublicSupportCY509Pct>0</PublicSupportCY509Pct>
      <InvestmentIncomeCYPct>0</InvestmentIncomeCYPct>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="00000003">
      <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="00000004" softwareId="13000178">
      <CYEndwmtFundGrp>
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        <ContributionsAmt>28522</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>2374654</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>211471</OtherExpendituresAmt>
        <EndYearBalanceAmt>12214292</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>8972182</BeginningYearBalanceAmt>
        <ContributionsAmt>42481</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>1401931</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>394007</OtherExpendituresAmt>
        <EndYearBalanceAmt>10022587</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>9425231</BeginningYearBalanceAmt>
        <ContributionsAmt>31630</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-349413</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>135266</OtherExpendituresAmt>
        <EndYearBalanceAmt>8972182</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>8583168</BeginningYearBalanceAmt>
        <ContributionsAmt>62590</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>1214176</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>434703</OtherExpendituresAmt>
        <EndYearBalanceAmt>9425231</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>7139823</BeginningYearBalanceAmt>
        <ContributionsAmt>59230</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>1783330</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>399215</OtherExpendituresAmt>
        <EndYearBalanceAmt>8583168</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <TotalRevEtcAuditedFinclStmtAmt>2574694</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>1234958</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>1234958</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>1339736</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>1339736</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>459580</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>459580</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>459580</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="00000005" softwareId="13000178">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>WCA HOSPITAL</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>FOOTE AVENUE</AddressLine1>
          <City>JAMESTOWN</City>
          <State>NY</State>
          <ZIPCode>14701</ZIPCode>
        </USAddress>
        <RecipientEIN>160743226</RecipientEIN>
        <IRCSectionDesc>170(B)(1)</IRCSectionDesc>
        <CashGrantAmt>529024</CashGrantAmt>
        <PurposeOfGrantTxt>SUPPORT ACTIVITIES RELATED TO COMMUNITY HEALTH</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION RECEIVES REQUESTS FROM THE SUPPORTED ORGANIZATION FOR GRANTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS APPROVES GRANTS BASED UPON THE AVAILABILITY OF FUNDS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>FROM INDIVIDUAL ENDOWMENTS THAT MATCH THE INTENDED PURPOSE OF THE ENDOWMENT OR FROM</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>UNRESTRICTED FUNDS. THE ORGANIZATION REIMBURSES THE SUPPORTED ORGANIZATION AS DOCUMENTED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>EVIDENCE IS PROVIDED THAT THE FUNDS HAVE BEEN EXPENDED.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="00000006">
      <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>BETSY WRIGHT</PersonNm>
        <CompensationBasedOnRltdOrgsAmt>340098</CompensationBasedOnRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>29580</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>20974</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>390652</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="00000007" softwareId="13000178">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS PROVIDED TO THE BOARD FOR THEIR REVIEW BEFORE</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>ITS SUBMISSION TO THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST DISCLOSURES ARE REVIEWED ON AN ANNUAL BASIS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS ONE PART TIME EMPLOYEE THAT IS COMPENSATED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>BASED UPON A SALARY WHICH IS APPROVED BY THE BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE FROM THE ORGANIZATION UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XI</FormAndLineReferenceDesc>
        <ExplanationTxt>NET UNREALIZED LOSSES ON INVESTMENTS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCE/AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>INDEPENDENT AUDITOR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="00000008" softwareId="13000178">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>WCA HOSPITAL</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>PO BOX 840 FOOTE AVENUE</AddressLine1>
          <City>JAMESTOWN</City>
          <State>NY</State>
          <ZIPCode>14701</ZIPCode>
        </USAddress>
        <EIN>160743226</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>170(B)(1)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>STARFLIGHT INC</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>207 FOOTE AVENUE</AddressLine1>
          <City>JAMESTOWN</City>
          <State>NY</State>
          <ZIPCode>14701</ZIPCode>
        </USAddress>
        <EIN>161557878</EIN>
        <PrimaryActivitiesTxt>MEDICAL TRANSPORTATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>170(B)(1)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1>WCA HOSPITAL</BusinessNameLine1>
        </OtherOrganizationName>
        <TransactionTypeTxt>b</TransactionTypeTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1>WCA HOSPITAL</BusinessNameLine1>
        </OtherOrganizationName>
        <TransactionTypeTxt>m</TransactionTypeTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>