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      <GrantsToDomesticOrgs>
        <Total>0</Total>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>203963</Total>
        <ProgramServices>173369</ProgramServices>
        <ManagementAndGeneral>30594</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>6164437</Total>
        <ProgramServices>5351198</ProgramServices>
        <ManagementAndGeneral>813239</ManagementAndGeneral>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>0</Total>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>27997</Total>
        <ProgramServices>6087</ProgramServices>
        <ManagementAndGeneral>21910</ManagementAndGeneral>
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      <OtherEmployeeBenefits>
        <Total>1389492</Total>
        <ProgramServices>616906</ProgramServices>
        <ManagementAndGeneral>772586</ManagementAndGeneral>
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      <PayrollTaxes>
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        <ProgramServices>340392</ProgramServices>
        <ManagementAndGeneral>321295</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>13667</Total>
        <ManagementAndGeneral>13667</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>59879</Total>
        <ManagementAndGeneral>59879</ManagementAndGeneral>
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      <FeesForServicesLobbying>
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      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
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      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
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        <ProgramServices>2937</ProgramServices>
        <ManagementAndGeneral>5499</ManagementAndGeneral>
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      <FeesForServicesOther>
        <Total>1127075</Total>
        <ProgramServices>1055048</ProgramServices>
        <ManagementAndGeneral>72027</ManagementAndGeneral>
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      <Advertising>
        <Total>102692</Total>
        <ManagementAndGeneral>102692</ManagementAndGeneral>
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      <OfficeExpenses>
        <Total>46005</Total>
        <ManagementAndGeneral>46005</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>0</Total>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>447288</Total>
        <ProgramServices>443164</ProgramServices>
        <ManagementAndGeneral>4124</ManagementAndGeneral>
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      <Travel>
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        <ProgramServices>2410</ProgramServices>
        <ManagementAndGeneral>25944</ManagementAndGeneral>
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      <TravelEntrtnmntPublicOfficials>
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      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>22009</Total>
        <ProgramServices>11200</ProgramServices>
        <ManagementAndGeneral>10809</ManagementAndGeneral>
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      <Interest>
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        <ProgramServices>738947</ProgramServices>
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      <PaymentsToAffiliates>
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      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>914056</Total>
        <ProgramServices>914056</ProgramServices>
      </DepreciationDepletion>
      <Insurance>
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        <ManagementAndGeneral>246638</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>MEDICAL &amp; OTHER SUPPLIES</Description>
        <Total>1154182</Total>
        <ProgramServices>1154182</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>FRANCHISE FEE</Description>
        <Total>333693</Total>
        <ManagementAndGeneral>333693</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>EMPLOYEE HIRING EXPENSE</Description>
        <Total>12004</Total>
        <ProgramServices>8778</ProgramServices>
        <ManagementAndGeneral>3226</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>PET CARE</Description>
        <Total>2344</Total>
        <ProgramServices>2344</ProgramServices>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>468742</Total>
        <ProgramServices>200279</ProgramServices>
        <ManagementAndGeneral>268463</ManagementAndGeneral>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>14173587</Total>
        <ProgramServices>11021297</ProgramServices>
        <ManagementAndGeneral>3152290</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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      <CashNonInterestBearing>
        <BOY>158510</BOY>
        <EOY>509069</EOY>
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      <SavingsAndTempCashInvestments>
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        <EOY>2432312</EOY>
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      <PledgesAndGrantsReceivable>
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        <EOY>0</EOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
        <BOY>931078</BOY>
        <EOY>1049066</EOY>
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      <ReceivablesFromOfficersEtc>
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        <EOY>0</EOY>
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      <ReceivablesFromDisqualPersons>
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        <EOY>0</EOY>
      </ReceivablesFromDisqualPersons>
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        <EOY>0</EOY>
      </OtherNotesLoansReceivableNet>
      <InventoriesForSaleOrUse>
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        <EOY>0</EOY>
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      <PrepaidExpensesDeferredCharges>
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      <LandBuildingsEquipmentBasis>28550156</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>12087025</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
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        <EOY>410555</EOY>
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      <InvestmentsOtherSecurities>
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        <EOY>0</EOY>
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      <InvestmentsProgramRelated>
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        <EOY>0</EOY>
      </InvestmentsProgramRelated>
      <IntangibleAssets>
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        <EOY>188652</EOY>
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      <OtherAssetsTotal>
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        <EOY>2092494</EOY>
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      <TotalAssets>
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        <EOY>23184335</EOY>
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      <AccountsPayableAccruedExpenses>
        <BOY>978697</BOY>
        <EOY>862729</EOY>
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      <GrantsPayable>
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        <EOY>12820000</EOY>
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      <OtherLiabilities>
        <BOY>2421342</BOY>
        <EOY>2320990</EOY>
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      <TotalLiabilities>
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        <EOY>16163494</EOY>
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      <FollowSFAS117>X</FollowSFAS117>
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        <EOY>27716</EOY>
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      <TotalNetAssetsFundBalances>
        <BOY>6062958</BOY>
        <EOY>7020841</EOY>
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      <TotalLiabNetAssetsFundBalances>
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        <EOY>23184335</EOY>
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      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>779138</ReconcilationRevenueExpenses>
      <ReconciliationUnrealizedInvest>30734</ReconciliationUnrealizedInvest>
      <ReconcilationOtherChanges>148011</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementSeparate>X</FinancialStatementSeparate>
      </FSAuditedBasis>
      <AuditCommittee>true</AuditCommittee>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
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    <IRS990ScheduleA documentId="IRS990ScheduleA">
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        <CurrentTaxYearMinus3Years>366596</CurrentTaxYearMinus3Years>
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        <CurrentTaxYearMinus1Year>140099</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>321728</CurrentTaxYear>
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        <CurrentTaxYearMinus3Years>13134982</CurrentTaxYearMinus3Years>
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        <CurrentTaxYearMinus1Year>14350153</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>14618588</CurrentTaxYear>
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      <GrossReceiptsFromNonUBI>
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      <TaxRevLeviedForOrgBenefit509>
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      <ValueOfSvcsFcltsFurnishdByGovt>
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      </ValueOfSvcsFcltsFurnishdByGovt>
      <Total509>
        <CurrentTaxYearMinus4Years>12881660</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>13501578</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>15059728</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>14490252</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>14940316</CurrentTaxYear>
        <Total>70873534</Total>
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      <AmtsRecdFromDisqualPersons>
        <Total>0</Total>
      </AmtsRecdFromDisqualPersons>
      <AmtsFromSubstContributors>
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      </AmtsFromSubstContributors>
      <SupportFromDQPsEtc>
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      </SupportFromDQPsEtc>
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      <GrossInvestmentIncome509>
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        <CurrentTaxYear>3398</CurrentTaxYear>
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      </GrossInvestmentIncome509>
      <Post1975UBTI>
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      </Post1975UBTI>
      <InvestmentIncomeAndUBTI>
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        <CurrentTaxYearMinus2Years>4158</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>4817</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>3398</CurrentTaxYear>
        <Total>52464</Total>
      </InvestmentIncomeAndUBTI>
      <NetIncomeFromOtherUBI>
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      </NetIncomeFromOtherUBI>
      <OtherIncome509>
        <CurrentTaxYearMinus4Years>8667</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>7665</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>2564</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>30845</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>13325</CurrentTaxYear>
        <Total>63066</Total>
      </OtherIncome509>
      <TotalSupportTotal>
        <CurrentTaxYearMinus4Years>12918478</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>13521183</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>15066450</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>14525914</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>14957039</CurrentTaxYear>
        <Total>70989064</Total>
      </TotalSupportTotal>
      <PublicSupportPercentage509>0.99837</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.99693</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0.00074</InvestmentIncomePercentage>
      <PriorYrInvestIncomePercentage>0.00190</PriorYrInvestIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
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        <BeginningOfYearBalance>83699</BeginningOfYearBalance>
        <Contributions>50</Contributions>
        <InvestmentEarningsOrLosses>5641</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>650</GrantsOrScholarships>
        <OtherExpenditures>0</OtherExpenditures>
        <AdministrativeExpenses>0</AdministrativeExpenses>
        <EndOfYearBalance>88740</EndOfYearBalance>
      </CurrentYearMinus3Years>
      <CurrentYearMinus4Years>
        <BeginningOfYearBalance>82404</BeginningOfYearBalance>
        <Contributions>1615</Contributions>
        <InvestmentEarningsOrLosses>-320</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>0</GrantsOrScholarships>
        <OtherExpenditures>0</OtherExpenditures>
        <AdministrativeExpenses>0</AdministrativeExpenses>
        <EndOfYearBalance>83699</EndOfYearBalance>
      </CurrentYearMinus4Years>
      <EndowmentsHeldByUnrelatedOrgs>false</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>true</EndowmentsHeldByRelatedOrgs>
      <AreRelatedOrgsListedScheduleR>true</AreRelatedOrgsListedScheduleR>
      <Land>
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        <BookValue>382591</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>23858435</OtherCostOrOtherBasis>
        <Depreciation>8805901</Depreciation>
        <BookValue>15052534</BookValue>
      </Buildings>
      <LeaseholdImprovements />
      <Equipment>
        <OtherCostOrOtherBasis>3449701</OtherCostOrOtherBasis>
        <Depreciation>2693096</Depreciation>
        <BookValue>756605</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>859429</OtherCostOrOtherBasis>
        <Depreciation>588028</Depreciation>
        <BookValue>271401</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>16463131</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>BENEFICIAL INT IN FOUNDATION</Description>
        <BookValue>1869814</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>DUE FROM FOUNDATION</Description>
        <BookValue>7969</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>DEPOSITS</Description>
        <BookValue>1000</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>LICENSE</Description>
        <BookValue>213711</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>2092494</TotalBookValueOtherAssets>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>INTEREST RATE SWAP LIABILITY</Description>
        <Amount>2311790</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>REFUNDABLE ADVANCE FEES</Description>
        <Amount>9200</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>2320990</TotalOfAmounts>
      <TotRevenueEtcAuditedFinclStmt>15131470</TotRevenueEtcAuditedFinclStmt>
      <NetUnrealizedGainsInvestments>30734</NetUnrealizedGainsInvestments>
      <OtherRevenues>148011</OtherRevenues>
      <RevenueNotRptdF990>178745</RevenueNotRptdF990>
      <RevenueSubtotal>14952725</RevenueSubtotal>
      <TotalRevenuePerForm990>14952725</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>14173587</TotExpensesEtcAuditedFinclStmt>
      <ExpensesSubtotal>14173587</ExpensesSubtotal>
      <TotalExpensesPerForm990>14173587</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIII>
        <Identifier>other income on financial statements not on return</Identifier>
        <ReturnReference>schedule D, Part XII, line 2d</ReturnReference>
        <Explanation>Change in valuation of interest in net assets of charitable foundation $89,059 Change in swap value $58,952</Explanation>
      </Form990ScheduleDPartXIII>
      <Form990ScheduleDPartXIII>
        <Identifier>use of endowment funds</Identifier>
        <ReturnReference>schedule d, part v, line 4</ReturnReference>
        <Explanation>TEMPORARILY RESTRICTED NET ASSETS ARE AVAILABLE FOR FUTURE CONSTRUCTION PROJECTS AND SCHOLARSHIPS TO EMPLOYEES. PERMANENTLY RESTRICTED NET ASSETS WERE DONATED TO ESTABLISH THE EDUCATIONAL, BUILDING, CHAPLAINCY, AND RESIDENT CARE ENDOWMENT FUNDS. INCOME EARNED ON PERMANENTLY RESTRICTED NET ASSETS IS AVAILABLE TO FUND EMPLOYEE SCHOLARSHIPS, FACILITY IMPROVEMENTS, CHAPLAIN SUPPORT SERVICES, AND TO SUBSIDIZE RESIDENT CARE.</Explanation>
      </Form990ScheduleDPartXIII>
      <Form990ScheduleDPartXIII>
        <Identifier>Other Changes in Net Assets</Identifier>
        <ReturnReference>schedule D, Part XI, line 8</ReturnReference>
        <Explanation>change in valuation of interest rate swap agreement $58,952 Change in valuation of interest in net assets of charitable foundation. $89,059</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <Form990ScheduleKPartI>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>County of Ashland Ohio</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>346000122</IssuerEIN>
        <CUSIPNumber>04417HAV3</CUSIPNumber>
        <DateIssued>2010-10-14</DateIssued>
        <IssuePrice>14005000</IssuePrice>
        <DescriptionOfPurpose>county of ashland, ohio health</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <BondReferenceCd>A</BondReferenceCd>
        <AmountRetired>14005000</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>0</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>13724900</RefundingEscrow>
        <IssuanceCostsFromProceeds>280100</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>0</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <YearOfSubstCompletion>2006</YearOfSubstCompletion>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <RemedialActionTaken>false</RemedialActionTaken>
        <NonQualifiedBondRemedProcdrs>false</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiled>false</Form8038TFiled>
        <RebateNotDueYet>true</RebateNotDueYet>
        <ExceptionToRebate>true</ExceptionToRebate>
        <VariableRateIssue>true</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>true</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>first merit bank</BusinessNameLine1>
        </NameOfHedgeProvider>
        <TermOfHedge>16.</TermOfHedge>
        <SuperintegratedHedge>true</SuperintegratedHedge>
        <HedgeTerminated>false</HedgeTerminated>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>false</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>A</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>false</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Rick Spreng</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>President of Board</Relationship>
        <AmountOfTransaction>261807</AmountOfTransaction>
        <DescriptionOfTransaction>Property/ liability Insurance</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>FORM 990 REVIEW PROCESS</Identifier>
        <ReturnReference>Form 990, PAGE 6, PART VI, #11B</ReturnReference>
        <Explanation>A COPY OF THE FORM 990 WILL BE SENT TO EACH BOARD MEMBER FOR THEIR REVIEW AND COMMENTS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DOCUMENTS AVAILABLE TO PUBLIC</Identifier>
        <ReturnReference>Form 990, PAGE 6, PART VI, #19</ReturnReference>
        <Explanation>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROCESS FOR DETERMINING COMPENSATION</Identifier>
        <ReturnReference>Form 990, PAGE 6, PART VI, SECTION B, #15</ReturnReference>
        <Explanation>THE CEO'S SALARY, BENEFITS, ETC. MUST BE APPROVED BY THE BOARD. ON AN ANNUAL BASIS, THE BOARD MEETS TO REVIEW THE CEO'S CONTRACT. BASED ON PERFORMANCE, EXPECTATIONS AND THE ECONOMY AN INCREASE MAY BE GRANTED. ANY INCREASE MUST BE SUBMITTED TO THE HUMAN RESOURCES AND FINANCE DEPARTMENTS FOR IMPLEMENTATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>tax-exempt bond description of purpose</Identifier>
        <ReturnReference>schedule k, part i, row a, column f</ReturnReference>
        <Explanation>Adjustable rate demand health care facilities revenue bonds series 2005 to retire Brethren Care, Inc.'s series 1999 series bonds and defease brethren care, inc.'s series 1996 bonds.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>MONITOR AND ENFORCE CONFLICT OF INTEREST POLICY</Identifier>
        <ReturnReference>Form 990, PAGE 6, PART VI, SECTION B, #12C</ReturnReference>
        <Explanation>BRETHREN CARE, INC. MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY REVIEWING, ON AN ANNUAL BASIS, THE POLICY AND HAVING EACH BOARD MEMBER SIGN OFF. BOARD MEMBERS COMPLETE FEDERAL FORM 990 BOARD MEMBER QUESTIONNAIRE FOR EVALUATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FAMILY OR BUSINESS RELATIONSHIP</Identifier>
        <ReturnReference>Form 990, PAGE 6, PART VI, SECTION A, #2</ReturnReference>
        <Explanation>RICK SPRENG HAS A BUSINESS RELATIONSHIP WITH JAY MYERS. BRETHREN CARE, INC. HAD A BUSINESS TRANSACTION THROUGH SPRENG-SMITH AGENCY WITH WHICH RICK SPRENG IS THE PRESIDENT. SPRENG-SMITH AGENCY WRITES INSURANCE FOR BRETHREN CARE, INC. BRETHREN CARE, INC. ALSO HAD A BUSINESS TRANSACTION THROUGH SIMONSON CONSTRUCTION SERVICES, INC. WITH WHICH JAY MYERS IS A PARTNER.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Other Changes in Net Assets</Identifier>
        <ReturnReference>Form 990, Page 12, Part XI, #5</ReturnReference>
        <Explanation>change in valuation of interest rate swap agreement $58,952. Change in valuation of interest in net assets of charitable foundation $89,059. unrealized gains on investments $30,734</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Brethren Care Foundation</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2140 Center Street</AddressLine1>
          <City>Ashland</City>
          <State>OH</State>
          <ZIPCode>44805</ZIPCode>
        </AddressUS>
        <EIN>341651905</EIN>
        <PrimaryActivities>support org</PrimaryActivities>
        <LegalDomicileState>OH</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>type3-other</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>