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        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT SCOTT JR</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
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        <OfficerInd>X</OfficerInd>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KEVIN BROWN</PersonNm>
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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>LOLY LARSON</PersonNm>
        <TitleTxt>BOARD MEMBER (THROUGH JANUARY 2025)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL MACHADO</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>YVONNE MAYORGA</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>AMY PIERCE</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>EMILIO VELA JR</PersonNm>
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        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>PHIL WILLIAMS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <TotalReportableCompFromOrgAmt>3602276</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>440409</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>85</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CHERVENELL CONSTRUCTION COMPANY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>107422 E DETRICK PR SE</AddressLine1Txt>
            <CityNm>KENNEWICK</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>99338</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION SERVICES</ServicesDesc>
        <CompensationAmt>15198694</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ATHENAHEALTH</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 415615</AddressLine1Txt>
            <CityNm>BOSTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>022415615</ZIPCd>
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        </ContractorAddress>
        <ServicesDesc>EHR, PRACTICE MGMT &amp; PATIENT BILLING</ServicesDesc>
        <CompensationAmt>1279357</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ABM JANITORIAL SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>14141 SOUTHWEST FREEWAY SUITE 400</AddressLine1Txt>
            <CityNm>SUGARLAND</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>77478</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>JANITORIAL SERVICES</ServicesDesc>
        <CompensationAmt>505472</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>KDA ARCHITECTURE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1310 N 16TH AVENUE</AddressLine1Txt>
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            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98902</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ARCHITECTURAL SERVICES</ServicesDesc>
        <CompensationAmt>495138</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>APFS STAFFING INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>7076 SOLUTIONS CENTER</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60677</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT CONSULTING SERVICES</ServicesDesc>
        <CompensationAmt>320527</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>14</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>9115444</GovernmentGrantsAmt>
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      <NoncashContributionsAmt>1366912</NoncashContributionsAmt>
      <TotalContributionsAmt>9445943</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>38419652</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>38419652</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>ENHANCEMENT REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>16614405</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>CAPITATION REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>3137326</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3137326</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
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        <BusinessCd>621400</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>44661</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>58216044</TotalProgramServiceRevenueAmt>
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        <ExclusionAmt>925079</ExclusionAmt>
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      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>4600163</SecuritiesAmt>
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      <NetGainOrLossInvestmentsGrp>
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        <ExclusionAmt>89136</ExclusionAmt>
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        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>44832</ExclusionAmt>
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      <TotalRevenueGrp>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>31551</ProgramServicesAmt>
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      <GrantsToDomesticIndividualsGrp>
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        <ProgramServicesAmt>30923</ProgramServicesAmt>
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        <ProgramServicesAmt>298570</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>8141</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>41783</ManagementAndGeneralAmt>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>75304</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>266230</ProgramServicesAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>50663</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>1234906</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>149352</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>632111</ProgramServicesAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
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      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
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        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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        <BookValueAmt>4096006</BookValueAmt>
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      <BuildingsGrp>
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        <BookValueAmt>63149284</BookValueAmt>
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        <BookValueAmt>174695</BookValueAmt>
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      <EquipmentGrp>
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        <DepreciationAmt>8368731</DepreciationAmt>
        <BookValueAmt>5166283</BookValueAmt>
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      <OtherLandBuildingsGrp>
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        <BookValueAmt>187151</BookValueAmt>
      </OtherLandBuildingsGrp>
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      <OtherLiabilitiesOrgGrp>
        <Desc>FAIR MARKET VALUE OF SWAP AGREEMENT</Desc>
        <Amt>200244</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>RIGHT-OF-USE LEASE LIABILITIES</Desc>
        <Amt>1024947</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS</Desc>
        <Amt>411883</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>1637074</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>68123045</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>197360</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>197360</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>67925685</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>75304</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>720045</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>795349</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>68721034</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>70531818</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>70531818</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>75304</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>632111</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>707415</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>71239233</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS A NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS USING A STANDARD THAT PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF MARCH 31, 2025 AND 2024, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRIBUTIONS WITH DONOR RESTRICTIONS 87,934. BAD DEBT EXPENSE 632,111.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE 632,111.</ExplanationTxt>
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    </IRS990ScheduleD>
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      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
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        <GrantTypeTxt>HELPING HANDS FUND</GrantTypeTxt>
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        <CashGrantAmt>30923</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>GRANTS ARE MADE TO LOCAL CHARITIES AND GOVERNMENT AGENCIES THAT ARE WELL KNOWN IN THE COMMUNITY. GRANTS ARE INTENDED FOR GENERAL OPERATING SUPPORT SO NO FOLLOW-UP IS CONDUCTED RELATED TO THE USE OF THE FUNDS. PER THE FUNDING POLICY, TO BE CONSIDERED FOR THE HELPING HANDS FUND, THE PATIENT'S HOUSEHOLD INCOME SHOULD NOT EXCEED TWO HUNDRED PERCENT (200%) OF THE POVERTY GUIDELINES. THE COMMITTEE WILL REVIEW AND VOTE ON ELIGIBLE APPLICATIONS ON A CASE BY CASE BASIS. FOR APPLICATIONS REFERRED BY PROVIDERS, AN URGENT NEED REQUEST FORM WILL BE COMPLETED BY THE PROVIDER AND SIGNED BY A COMMITTEE MEMBER. IF THE ESTIMATED COST IS BETWEEN $200 AND $299, A MANAGEMENT TEAM MEMBER'S SIGNATURE IS ALSO REQUIRED. URGENT NEED REQUEST EQUAL TO OR GREATER THAN $300 MUST BE APPROVED BY THE COMMITTEE VIA EMAIL VOTE BEFORE FUNDING CAN OCCUR. NON URGENT NEED APPLICATIONS WILL BE REVIEWED AT MONTHLY COMMITTEE MEETINGS. PAYMENTS ARE MADE DIRECTLY TO CREDITORS TO ENSURE PROPER USE OF ALL FUNDS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
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      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
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      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>1</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TOBE HARBERD</PersonNm>
        <TitleTxt>RTT SITE DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>347661</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationFilingOrgAmt>1038</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>14919</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>30262</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>411520</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR FELIPE GUTIERREZ</PersonNm>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>395860</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <BonusFilingOrganizationAmount>17836</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14270</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>30262</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>386183</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MANUEL NAVARRO</PersonNm>
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        <BonusFilingOrganizationAmount>37113</BonusFilingOrganizationAmount>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12704</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>30262</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>359708</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NATHAN SCHREIBER</PersonNm>
        <TitleTxt>ASSOCIATE MEDICAL DIRECTOR</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>17426</BonusFilingOrganizationAmount>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12859</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>30262</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR JEFFERY HINCKLEY</PersonNm>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR ANDREW GRAY</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <PersonNm>DANIELLE NOELL</PersonNm>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUMMER KELLEY</PersonNm>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>225025</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR SUSAN CAVERLY EXECUTIVE</PersonNm>
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        <PersonNm>MICHAEL ROMINE</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 1A</FormAndLineReferenceDesc>
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      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S LEADERSHIP TEAM PARTICIPATES IN AN INCENTIVE-BASED PROGRAM WITH FOUR PILLARS, INCLUDING FINANCIAL SUSTAINABILITY (I.E. OPERATING MARGIN), CUSTOMER SATISFACTION, QUALITY AND EXCELLENCE OF CARE, AND EMPLOYEE SATISFACTION AND RETENTION. EACH PILLAR IS EQUALLY WEIGHTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>IN 2024, THE CEO RECEIVED A DISCRETIONARY BONUS AS DETERMINED BY THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>WASHINGTON HEALTH CARE FACILITIES AUTHORITY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>911108929</BondIssuerEIN>
        <BondIssuedDt>2022-02-17</BondIssuedDt>
        <IssuePriceAmt>24600000</IssuePriceAmt>
        <PurposeDesc>BUILDING EXPANSION AND REFINANCE SERIES 2017 BONDS</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>WASHINGTON HEALTH CARE FACILITIES AUTHORITY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>911108929</BondIssuerEIN>
        <BondIssuedDt>2024-03-22</BondIssuedDt>
        <IssuePriceAmt>15000000</IssuePriceAmt>
        <PurposeDesc>BUILDING EXPANSION</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>1631583</RetiredAmt>
        <TotalProceedsAmt>24600000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>220013</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>16823243</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>7556744</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>0</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceedsAmt>15000000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>179509</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>14820491</CapitalExpendituresAmt>
        <SubstantialCompletionYr>2025</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>13564</ContributionCnt>
        <NoncashContributionsRptF990Amt>1366912</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>INVOICE PRICE</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>0</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, COLUMN (B):</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS REPORTED IN PART I, COLUMN B REPRESENT THE NUMBER OF DONATED ITEMS RECEIVED DURING THE FISCAL YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS OF THE BOARD AND ONE AT-LARGE BOARD MEMBER. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO REVIEW AND TAKE ANY NECESSARY ACTION THAT, IN THE OPINION OF A MAJORITY OF THE COMMITTEE, CANNOT WAIT FOR THE NEXT REGULARLY SCHEDULED BOARD MEETING OR WHERE THE CALLING OF A SPECIAL BOARD MEETING IS NOT PRACTICAL. THE EXECUTIVE COMMITTEE CHAIR MUST REPORT TO THE BOARD AT ITS NEXT REGULAR MEETING ALL ACTIONS TAKEN BY THE COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIOR TO FILING WITH THE IRS, A DRAFT OF THE FORM 990 WAS REVIEWED BY THE ACCOUNTING TEAM AND THE CFO, THEN PRESENTED TO THE FINANCE COMMITTEE, A SUBCOMMITTEE OF THE BOARD. THE FINANCE COMMITTEE REVIEWED THE FORM 990 AND THEN PRESENTED ITS RECOMMENDATION TO THE BOARD OF DIRECTORS TO FILE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH BOARD MEMBER SIGNS THE CONFLICT OF INTEREST STATEMENT WHEN THEY JOIN THE BOARD. IN ADDITION, AT THE ANNUAL BOARD MEETING IN MARCH ALL BOARD MEMBERS SIGN THE STATEMENT AGAIN TO ENSURE NOTHING HAS CHANGED FROM THE PRIOR YEAR OR TO BRING ATTENTION TO SOMETHING THAT HAS. ALSO, BOARD MEMBERS ARE ENCOURAGED TO DISCLOSE NEW INFORMATION THAT MIGHT COME UP AFTER THE STATEMENT WAS SIGNED. IF A CONFLICT EXISTS, THAT BOARD MEMBER DOES NOT VOTE ON THE MATTER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>SALARY DATA IS PULLED FROM MULTIPLE SALARY SURVEY SOURCES, IN ADDITION TO INDEPENDENT SALARY SURVEYS CONDUCTED THROUGH HR. THE BOARD OF DIRECTORS'S COMPENSATION COMMITTEE REVIEWS AND APPROVES THE CEO'S COMPENSATION. THE CEO REVIEWS AND APPROVES ALL OTHER EMPLOYEES' COMPENSATION. THE PROCESS WAS LAST COMPLETED IN 2025.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, BUT THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -83,817.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUTHORITY AND PROCESS FOR SELECTING THE FINANCIAL STATEMENT AUDITOR AND FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE FISCAL YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>