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        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>276241</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33940</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT UNDERWOOD</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>377345</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33286</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FARAZ SANDHU</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>1226417</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31785</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GRAHAM TULL</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>705888</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23211</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JONATHAN JONES</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
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        <OtherCompensationAmt>23978</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DOMINIC CANNELLA</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES BOYD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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        <OtherCompensationAmt>33435</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JEFF BOURGEOIS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>85275</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN BUFFINGTON</PersonNm>
        <TitleTxt>FORMER - COO</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13846</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAREN MILLER</PersonNm>
        <TitleTxt>FORMER - CFO</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>379995</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28624</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rick Wallace</PersonNm>
        <TitleTxt>FORMER - CEO</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>241154</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19307</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>8248401</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>425662</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>222</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>true</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>ARAMARK</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>12483 COLLECTIONS CENTER DRIVE</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60693</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HOUSEKEEPING SERVICE</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>MIDLAND CAPITAL RESOURCES</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5020 BOB BILLINGS RESOURCES</AddressLine1Txt>
            <CityNm>LAWRENCE</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66049</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>COLLECTIONS</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>QUEST DIAGNOSTICS</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3924 COLLECTION CENTER DRIVE</AddressLine1Txt>
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            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60693</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>CERNER CORPORATION</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2800 ROCKCREEK PARKWAY</AddressLine1Txt>
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            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>64117</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>INFORMATION TECH</ServicesDesc>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>MEDICAL INFORMATION TECHNOLOGY</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>MEDITECH CIRCLE</AddressLine1Txt>
            <CityNm>WESTWOOD</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02090</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE</ServicesDesc>
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      <CntrctRcvdGreaterThan100KCnt>19</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>31000</RelatedOrganizationsAmt>
      <AllOtherContributionsAmt>2159014</AllOtherContributionsAmt>
      <TotalContributionsAmt>2190014</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>248831440</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>248831440</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER PROGRAM SERVICE REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1721818</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1721818</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEANINGFUL USE REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>30014</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>30014</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>EQUITY IN SJR REHAB &amp; SJR HOLDING</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>457584</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PROGRAM RELATED RENTAL INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>248888</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>248888</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>251289744</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>8380880</TotalRevenueColumnAmt>
        <ExclusionAmt>8380880</ExclusionAmt>
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      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>42233</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>42233</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>42233</TotalRevenueColumnAmt>
        <ExclusionAmt>42233</ExclusionAmt>
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      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>101073143</SecuritiesAmt>
        <OtherAmt>1038862</OtherAmt>
      </GrossAmountSalesAssetsGrp>
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        <OtherAmt>1454688</OtherAmt>
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      <NetGainOrLossInvestmentsGrp>
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        <ExclusionAmt>626436</ExclusionAmt>
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      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
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      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>722514</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>540240</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>578969</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAFETERIA</Desc>
        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>1265741</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>2384950</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>264914257</TotalRevenueColumnAmt>
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        <ExclusionAmt>10894259</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
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        <TotalAmt>64020</TotalAmt>
        <ProgramServicesAmt>64020</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2729754</TotalAmt>
        <ProgramServicesAmt>173340</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2556414</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>362367</ProgramServicesAmt>
        <ManagementAndGeneralAmt>705095</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>124687903</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11901983</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>2805212</ProgramServicesAmt>
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        <ProgramServicesAmt>20831010</ProgramServicesAmt>
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        <ProgramServicesAmt>7944081</ProgramServicesAmt>
        <ManagementAndGeneralAmt>717808</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
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      <FeesForServicesLegalGrp>
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        <ProgramServicesAmt>16459</ProgramServicesAmt>
        <ManagementAndGeneralAmt>772211</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>164998</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>70239</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>641534</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>17739778</ProgramServicesAmt>
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        <ProgramServicesAmt>2704863</ProgramServicesAmt>
        <ManagementAndGeneralAmt>100138</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>252449</ProgramServicesAmt>
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        <ProgramServicesAmt>772362</ProgramServicesAmt>
        <ManagementAndGeneralAmt>62805</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1032620</ProgramServicesAmt>
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      <PaymentsToAffiliatesGrp>
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        <ProgramServicesAmt>14231029</ProgramServicesAmt>
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        <ProgramServicesAmt>1427156</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2461173</ManagementAndGeneralAmt>
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        <Desc>Equipment Rental</Desc>
        <TotalAmt>6807143</TotalAmt>
        <ProgramServicesAmt>6734057</ProgramServicesAmt>
        <ManagementAndGeneralAmt>73086</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
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        <ProgramServicesAmt>13043280</ProgramServicesAmt>
        <ManagementAndGeneralAmt>199</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Miscellaneous Expense</Desc>
        <TotalAmt>379027</TotalAmt>
        <ProgramServicesAmt>342151</ProgramServicesAmt>
        <ManagementAndGeneralAmt>36876</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>273779892</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29315031</ManagementAndGeneralAmt>
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        <EOYAmt>11131676</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>53175543</BOYAmt>
        <EOYAmt>41543441</EOYAmt>
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      <ReceivablesFromOfficersEtcGrp>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>240504</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>4479118</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>3849474</EOYAmt>
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      <LandBldgEquipAccumDeprecAmt>224142224</LandBldgEquipAccumDeprecAmt>
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        <BOYAmt>159115873</BOYAmt>
        <EOYAmt>150091552</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>120430788</BOYAmt>
        <EOYAmt>141987123</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>2564352</BOYAmt>
        <EOYAmt>3566366</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>6872915</BOYAmt>
        <EOYAmt>6328485</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>13965473</BOYAmt>
        <EOYAmt>26148464</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>420125704</BOYAmt>
        <EOYAmt>389366203</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>35465550</BOYAmt>
        <EOYAmt>36443866</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>27013502</BOYAmt>
        <EOYAmt>23547389</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>28412974</BOYAmt>
        <EOYAmt>24496535</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>22071389</BOYAmt>
        <EOYAmt>35926237</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>112963415</BOYAmt>
        <EOYAmt>120414027</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>307162289</BOYAmt>
        <EOYAmt>268952176</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PermanentlyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>307162289</BOYAmt>
        <EOYAmt>268952176</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>420125704</BOYAmt>
        <EOYAmt>389366203</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-38180666</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-29447</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <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>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbyingGrp />
      <TotalDirectLobbyingGrp />
      <TotalLobbyingExpendGrp />
      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>true</DirectContactLegislatorsInd>
      <DirectContactLegislatorsAmt>70239</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>false</OtherActivitiesInd>
      <TotalLobbyingExpendituresAmt>70239</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule C, Part II-B, Line 1g</FormAndLineReferenceDesc>
        <ExplanationTxt>Lobbying: San Juan regional medical center paid New Mexico government affairs $49,085 for a lobbyist in Santa Fe, New Mexico who monitors New Mexico state legislative issues regarding hospital issues, keeps san juan regional medical center apprised of those issues and takes feedback to the state legislature. A portion of the dues paid to the healthcare associations by san juan regional medical center was allocable to lobbying activities. The amount for the fiscal year ended 06/30/18 was $21,154.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
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        <OtherCostOrOtherBasisAmt>8092297</OtherCostOrOtherBasisAmt>
        <BookValueAmt>8092297</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>181511145</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>97553096</DepreciationAmt>
        <BookValueAmt>83958049</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>89427</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>89427</DepreciationAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>161884080</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>116314390</DepreciationAmt>
        <BookValueAmt>45569690</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>22656827</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>10185311</DepreciationAmt>
        <BookValueAmt>12471516</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>150091552</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Bond Issuance Costs</Desc>
        <BookValueAmt>361334</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Insurance Receivable</Desc>
        <BookValueAmt>25262000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Due from Related Entity</Desc>
        <BookValueAmt>525130</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>26148464</TotalBookValueOtherAssetsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>MALPRACTICE LIABILITY</Desc>
        <Amt>31920000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>BOND INTEREST PAYABLE</Desc>
        <Amt>94232</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to Medicare/Medicaid</Desc>
        <Amt>3912005</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>35926237</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>264884810</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-29447</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-29447</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>264914257</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>264914257</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>303094923</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>303094923</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>303094923</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART X, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent400Ind>X</Percent400Ind>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>true</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>false</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>false</AnnualCommunityBnftReportInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>3302634</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>3302634</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01090</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
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        <NetCommunityBenefitExpnsAmt>37974111</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.12530</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
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        <NetCommunityBenefitExpnsAmt>2864274</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00950</TotalExpensePct>
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      <TotalFinancialAssistanceTyp>
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        <NetCommunityBenefitExpnsAmt>44141019</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.14570</TotalExpensePct>
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      <CommunityHealthServicesGrp>
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        <NetCommunityBenefitExpnsAmt>930089</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00310</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
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        <NetCommunityBenefitExpnsAmt>1012364</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00330</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
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        <NetCommunityBenefitExpnsAmt>8715157</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02870</TotalExpensePct>
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        <NetCommunityBenefitExpnsAmt>64020</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00020</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
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        <DirectOffsettingRevenueAmt>31193610</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>10721630</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03530</TotalExpensePct>
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      <TotalCommunityBenefitsGrp>
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        <NetCommunityBenefitExpnsAmt>54862649</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.18100</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>4754415</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>2139487</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>73725843</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>76116983</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-2391140</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostAccountingSystemInd>X</CostAccountingSystemInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>SAN JUAN REGIONAL MEDICAL CENTER</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>801 WEST MAPLE STREET</AddressLine1Txt>
          <CityNm>FARMINGTON</CityNm>
          <StateAbbreviationCd>NM</StateAbbreviationCd>
          <ZIPCd>87401</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>WWW.SANJUANREGIONAL.COM</WebsiteAddressTxt>
        <StateLicenseNum>6291</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>1</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>SAN JUAN REGIONAL MEDICAL CENTER</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
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        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>17</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>true</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>false</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>SEE PART V, SECTION C FOR URL</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>17</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>SEE PART V, SECTION C FOR URL</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>PART V, SECTION C FOR URL</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>PART V, SECTION C FOR URL</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>PART V, SECTION C FOR URL</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicaidMedcrPrvtInd>X</LookBackMedicaidMedcrPrvtInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, DATA WAS OBTAINED FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (THE PRC COMMUNITY HEALTH SURVEY) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR TRENDING AND COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH AN ONLINE KEY INFORMANT SURVEY. SURVEY PARTICIPANTS INCLUDED 67 KEY INFORMANTS, INCLUDING PHYSICIANS, PUBLIC HEALTH EXPERTS, OTHER HEALTH PROVIDERS, SOCIAL SERVICE REPRESENTATIVES AND COMMUNITY LEADERS. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATION WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. PARTICIPATION INCLUDED REPRESENTATION FROM THE FOLLOWING ORGANIZATIONS: - 4 CORNERS ECONOMIC DEVELOPMENT - ADULT PROTECTIVE SERVICES - CEDAR RIDGE INN NURSING HOME AND REHABILITATION - CITY OF AZTEC - CITY OF BLOOMFIELD - CITY OF FARMINGTON - DAILY TIMES - DEPARTMENT OF PUBLIC HEALTH - ECHO INC. - FARMINGTON CHAMBER OF COMMERCE - FARMINGTON MUNICIPAL SCHOOLS - FARMINGTON POLICE DEPARTMENT - FIRE DEPARTMENT - GUARDIAN ANGEL HOME HEALTH, INC. - LA MESA CHIROPRACTIC AND REHABILITATION CENTER INC. - LIFE CARE CENTER OF FARMINGTON - PESCO - PMS CHILDREN SERVICES - RAM STUDIOS INC. - SAN JUAN COUNTY PARTNERSHIP, INC. - SAN JUAN COUNTY PUBLIC HEALTH OFFICE - SAN JUAN COUNTY, NEW MEXICO - SAN JUAN REGIONAL REHABILITATION HOSPITAL</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 6A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHNA WAS CONDUCTED WITH SAN JUAN REGIONAL REHABILITATION HOSPITAL.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>direct url for community health needs assessment on hospital's website: https://www.sanjuanregional.com/upload/docs/About%20Us/Community%20Reinves tment/2017CHNA.pdf</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 11</FormAndLineReferenceDesc>
        <ExplanationTxt>SAN JUAN REGIONAL MEDICAL CENTER HAS CONDUCTED FOUR COMMUNITY HEALTH NEEDS ASSESSMENTS SINCE 2008 AND EVERY ASSESSMENT IDENTIFIED THE FOLLOWING AS TOP ISSUES: - CHRONIC DISEASE, ESPECIALLY DIABETES AND HEART DISEASE; - CULTURALLY SENSITIVE COMMUNICATION AND HEALTH INFORMATION; - GREATER PUBLIC OUTREACH; - SUICIDE PREVENTION THE BOARD OF DIRECTORS, THROUGH THE PARTNERSHIP SUB-COMMITTEE OF THE BOARD, PROVIDES GRANTS TO OTHER NOT FOR PROFIT ORGANIZATIONS THROUGH ITS COMMUNITY REINVESTMENT FUND. THE BOARD MADE THE DECISION TO LIMIT THE GRANTS TO ORGANIZATIONS THAT ADDRESS THE TOP ISSUES IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. WE ALSO MATCH THE DONATIONS OF OUR EMPLOYEES-DOLLAR FOR DOLLAR-TO THE UNITED WAY OF SAN JUAN COUNTY THROUGH THE COMMUNITY REINVESTMENT FUND. FURTHERMORE, WE ADDRESS THESE TOP ISSUES THROUGH ACTIVITIES WITHIN THE HOSPITAL. OUTREACH: - FLU CLINICS - HEALTH FAIRS - LOW COST BLOOD SCREENINGS CULTURALLY SENSITIVE COMMUNICATION AND HEALTH INFORMATION: - SPANISH TRANSLATION OF HEALTH INFORMATION - HEALTH INFORMATION SPOTS ON KNDN, THE NAVAJO RADIO STATION - TRANSLATION OF SIGNAGE - TRANSLATOR SERVICES CHRONIC DISEASE MANAGEMENT - DIABETES EDUCATION AND LIFESTYLE BALANCE - STROKE PREVENTION - DIETARY CONSULTS - OUTREACH AND EDUCATION OF CHILDREN THROUGH MR. JUAN HART AND HEALTHY FET KIDS - YEAR ROUND LOW COST BLOOD SCREENINGS SAN JUAN REGIONAL MEDICAL CENTER HAS EXPANDED MENTAL HEALTH SERVICES TO IMPROVE ACCESS TO BEHAVIORAL HEALTH CARE. IT IS NOT POSSIBLE, FROM A FINANCIAL OR HUMAN RESOURCE STANDPOINT TO ADDRESS ALL THE ISSUES IN THE CHNA, THEREFORE WE CHOSE THE TOP ISSUES THAT WE FELT WE COULD IMPACT. THE NEEDS NOT BEING ADDRESSED ARE CHRONIC DISEASE AND SUICIDE PREVENTION. SAN JUAN REGIONAL MEDICAL CENTER HAS EXPANDED MENTAL HEALTH SERVICES TO IMPROVE ACCESS TO BEHAVIORAL HEALTH CARE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 16A-16C</FormAndLineReferenceDesc>
        <ExplanationTxt>WEBSITE URL WHERE YOU CAN FIND THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP: http://www.sanjuanregional.com/EnglishForms</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>25</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC CARDIOLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>407 S SCHWARTZ SUITE 202</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC INTERNAL MEDICINE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>407 S SCHWARTZ SUITE 201</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SAN JUAN NEURODIAGNOSTIC CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>407 S SCHWARTZ SUITE 101</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SAN JUAN PEDIATRICS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>407 S SCHWARTZ SUITE 102</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FOUR CORNERS NEUROSURGERY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>407 S SCHWARTZ SUITE 101</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC MIDWIFERY CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>655 WEST PINON</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>OUTPATIENT BEHAVIORAL HEALTH CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>555 S SCHWARTZ</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>URGENT CARE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4820 E MAIN STREET</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87402</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJR WOUND CARE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4251 ENGLISH ROAD</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87402</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJR CANCER TREATMENT CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>731 W ANIMAS STREET</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC OUTPATIENT DIAGNOSTIC CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2300 E 30TH STREET BLDG C</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC EMS STATION- MEDIC #1</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>730 S LAKE STREET</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC EMS STATION- MEDIC #2</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>902 W BROADWAY</AddressLine1Txt>
            <CityNm>BLOOMFIELD</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87412</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC EMS STATION- MEDIC #3</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>484 S OLIVER STREET</AddressLine1Txt>
            <CityNm>AZTEC</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87410</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC EMS STATION- MEDIC #4</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4 CR 3660</AddressLine1Txt>
            <CityNm>KIRTLAND</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87117</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC EMS STATION- MEDIC #5</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>3782 ENGLISH ROAD</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87402</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC EMS STATION- MEDIC #6</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2014 E 16TH STREET</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC EMS STATION- MEDIC #10</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>737 W ANIMAS STREET</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC AZTEC CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>120 LLANO STREET</AddressLine1Txt>
            <CityNm>AZTEC</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87410</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>GENERAL SURGERY CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>630 W MAPLE</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC AUDIOLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>816 W MAPLE</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC OUTPATIENT REHABILITATION</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>301 S AUBURN AVE</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC PEDIATRIC OUTPATIENT REHAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>810 W MAPLE</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC BARKMAN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>102 LLANO ST</AddressLine1Txt>
            <CityNm>AZTEC</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87410</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SJRMC ENDOSCOPY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>950 W PINON</AddressLine1Txt>
            <CityNm>FARMINGTON</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87401</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, Line 3c</FormAndLineReferenceDesc>
        <ExplanationTxt>Description of Additional criteria used in determining eligibility for financial assistance: IN addition to the federal poverty guidelines SJRMC also considers the patient asset level, medical Indigency, insurance status, underinsurance status and residency.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A - 7C. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE INFORMATION FOR LINES 7E - 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7G</FormAndLineReferenceDesc>
        <ExplanationTxt>SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) PROVIDES NUMEROUS SUBSIDIZED HEALTH SERVICES TO THE COMMUNITY. INCLUDED IN THE SUBSIDIZED SERVICES ARE FREESTANDING PHYSICIAN CLINICS WHICH ALLOW SJRMC TO BRING IN MORE SPECIALTIES AND BETTER SERVE THE COMMUNITY. THE NEAREST CITY THAT WOULD HAVE SIMILAR SERVICES THAT THE CLINICS OFFER WOULD BE ABOUT AN HOUR AWAY. THERE ARE SOME INDEPENDENTLY OWNED CLINICS WITHIN THIS COMMUNITY, BUT HAVE VERY STRINGENT GUIDELINES ON WHICH PATIENTS THEY WILL TAKE. THE TOTAL COSTS RELATED TO THE PHYSICIAN CLINICS INCLUDED ON LINE 7G ARE $39,908,768 WITH DIRECT OFFSETTING REVENUE OF $31,193,610, RESULTING IN A NET COMMUNITY BENEFIT EXPENSE OF $8,715,157.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED June 30, 2019. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNT ON LINE 3 IS AN ESTIMATE BASED ON MANAGEMENT'S BELIEF OF THE PERCENTAGE OF ADDITIONAL FINANCIAL ASSISTANCE COST IF THE PATIENTS WOULD COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THIS AMOUNT IS CURRENTLY ESTIMATED BETWEEN 45-60%, WHICH IS INCLUDED IN OUR BAD DEBT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, SECTION B, LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNT OF MEDICARE SHORTFALL REPORTED ON LINE 7 IS $-2,391,143. THIS AMOUNT IS A RESULT OF THE TOTAL REVENUE AND ALLOWABLE COST CALCULATION ON OUR FISCAL YEAR 19 COST REPORT. THE HOSPITAL'S ACTUAL EXPENSES ARE ENTERED INTO THE COST REPORT SOFTWARE AND THE ALLOWABLE COSTS ARE DETERMINED BY MEDICARE REGULATIONS. THIS MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE, ABSENT THIS PROGRAM, MANY INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER NEEDS- BASED PROGRAMS. BY ACCEPTING PAYMENTS BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF THE GOVERNMENT ARE RELIEVED, AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, SECTION C, LINE 9B</FormAndLineReferenceDesc>
        <ExplanationTxt>SAN JUAN REGIONAL MEDICAL CENTER'S (SJRMC) POLICY ON PATIENT ACCOUNT COLLECTIONS STATES SJRMC WILL NOT ATTEMPT TO COLLECT FROM A PATIENT WHO IS APPLYING FOR THE SAN JUAN COUNTY INDIGENT FUND AS LONG AS THE PATIENT IS COOPERATING WITH THE APPLICATION PROCESS. THE POLICY ALSO STATES SJRMC WILL NOT COLLECT FROM A PATIENT APPLYING FOR THE COMMUNITY SERVICE FUND (FINANCIAL ASSISTANCE) AS LONG AS THE PATIENT IS COOPERATING WITH THE APPLICATION PROCESS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>NEEDS ASSESSMENT: A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS CONDUCTED BY SAN JUAN REGIONAL MEDICAL CENTER TO DETERMINE THE HEALTH NEEDS FOR SAN JUAN COUNTY AND THE FOUR CORNERS REGION AS PERCEIVED BY THOSE SERVED BY THE HOSPITAL. THE CHNA IS CONDUCTED VIA TELEPHONE SURVEYS IN BOTH ENGLISH AND SPANISH, INTERVIEWS CONDUCTED WITH NATIVE AMERICAN RESPONDENTS, KEY SHAREHOLDERS IN THE PROVISION OF HEALTH CARE IN SAN JUAN COUNTY, AND A SERIES OF FOCUS GROUPS. THE SURVEY IS ALSO SHARED WITH KEY COMMUNITY GROUPS IN A SERIES OF OPEN FORUMS. THE MOST RECENT CHNA OCCURRED IN CY 2017 (FY 2017). THE NEEDS WHICH WERE IDENTIFIED FROM THIS SURVEY INCLUDE: ACCESS TO HEALTH CARE SERVICES, CANCER, DIABETES, HEART DISEASE AND STROKE, INFANT HEALTH AND FAMILY PLANNING, INJURY AND VIOLENCE, MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY AND WEIGHT, POTENTIALLY DISABLING CONDITIONS, RESPIRATOTY DISEASES, SUBSTANCE ABUSE, AND TOBACCO. THE SAN JUAN REGIONAL MEDICAL CENTER BOARD OF DIRECTORS AND HOSPITAL ADMINISTRATION CONDUCTS THE SURVEY FOR THE PURPOSE OF DETERMINING HOW BEST TO DIRECT RESOURCES TO IMPROVE THE HEALTH OF THE FOUR CORNERS WITH THREE GOALS IN MIND -TO IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE - TO REDUCE HEALTH DISPARITIES AMONG RESIDENTS BY IDENTIFYING POPULATION SEGMENTS WHO ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE INDIVIDUALS ARE ALSO DEVELOPED TO COMBAT SOME OF THE SOCIO-ECONOMIC FACTORS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH - TO INCREASE ACCESSIBILITY TO PREVENTATIVE SERVICES FOR ALL COMMUNITY RESIDENTS, MORE ACCESSIBLE PREVENTIVE SERVICES WILL PROVE BENEFICIAL IN ACCOMPLISHING THE FIRST GOAL (IMPROVING HEALTH STATUS, INCREASING LIFE SPANS, AND ELEVATING QUALITY OF LIFE), AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASES RESULTING FROM A LACK OF PREVENTIVE CARE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SAN JUAN REGIONAL MEDICAL CENTER EMPLOYS A NUMBER OF FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES WHO WORK ALONGSIDE PATIENTS TO HELP THEM NAVIGATE THEIR PAYMENT, BILLING AND ASSISTANCE OPTIONS. INFORMATION IS DISSEMINATED TO PATIENTS THROUGH ONLINE AND PAPER RESOURCES LOCATED THROUGHOUT THE HOSPITAL. A WIDELY DISTRIBUTED BROCHURE TITLED PAYING FOR HOSPITAL SERVICES AT SAN JUAN REGIONAL MEDICAL CENTER IS SPECIFICALLY DESIGNED TO HELP PATIENTS UNDERSTAND THEIR HOSPITAL BILL AND INFORM THEM OF THEIR OPTIONS FOR PAYMENT AND ASSISTANCE INCLUDING INFORMATION ON THE AVAILABILITY OF INDIAN HEALTH SERVICE ASSISTANCE, CASH DISCOUNTS, BILL REDUCTION THROUGH A COMMUNITY SERVICE FUND, SPECIAL FUNDS THROUGH THE SAN JUAN COUNTY INDIGNANT FUND, OR MEDICAL HARDSHIP WAIVERS. THE HOSPITAL'S VISION IS TO BE KNOWN AS THE MOST PERSONALIZED QUALITY HEALTHCARE PROVIDER. SAN JUAN REGIONAL MEDICAL CENTER IS ALSO A VALUES-DRIVEN ORGANIZATION WITH A CENTURY OF SERVICE TO THE FOUR CORNERS REGION- DRIVEN BY A SIMPLE, YET POWERFUL PRINCIPLE, DO THE RIGHT THING FOR THE PATIENT, NO MATTER WHAT. AN INTEGRAL PART OF THIS SACRED TRUST THE COMMUNITY HAS IN ITS HOSPITAL IS ENSURING THAT NO PATIENT FEELS ALONE AND DISCONNECTED DURING AND AFTER THEIR TREATMENT. THEREFORE, IT IS IN THE SPIRIT OF THE HOSPITAL'S VISION AND MISSION TO ENSURE THAT PATIENTS RECEIVE A HIGH LEVEL OF ASSISTANCE WHEN FIGURING OUT THEIR BILL AND OPTIONS. NOT ONLY DOES THE HOSPITAL HAVE FINANCIAL COUNSELORS TO EDUCATE ITS PATIENTS, IT HAS AN IN-HOUSE MEDICAL ADVOCACY SERVICE FOR HEALTHCARE PROGRAM (MASH) FOR SELF-PAY INDIVIDUALS. THROUGH THE MASH PROGRAM, PATIENT ADVOCATES STAND HAND-IN-HAND WITH PATIENTS TO EXPLORE EVERY POSSIBILITY OF ASSISTANCE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY INFORMATION: SAN JUAN REGIONAL MEDICAL CENTER SERVES THE FOUR CORNERS REGION OF THE UNITED STATES, WHICH IS MOSTLY RURAL. THE HOSPITAL IS LOCATED IN THE REGION'S LARGEST CITY AND ONLY METROPOLITAN AREA, WHICH IS FARMINGTON, NEW MEXICO. OTHER CITIES IN THE REGION INCLUDE CORTEZ AND DURANGO IN COLORADO, MONTICELLO AND BLANDING IN UTAH, KAYENTA AND CHINLE IN ARIZONA, AND SHIPROCK, AZTEC, AND BLOOMFIELD IN NEW MEXICO. THIS REGION ALSO INCLUDES THE NAVAJO NATION. STATISTICS GATHERED FOR THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT IN 2011 FOR SAN JUAN COUNTY (POPULATION 130,044)- WHICH IS THE PRINCIPAL COUNTY SERVED BY SAN JUAN REGIONAL MEDICAL CENTER- INDICATE THE FOLLOWING POPULATION CHARACTERISTICS: MEN 49.6%, WOMEN 50.4%, AGES 18 AND UNDER 29%, AGES 65+ 10.8%, WHITE 51.6% AMERICAN INDIAN AND ALASKA NATIVE 36.6% HISPANIC 19.1%. THE MEDIAN HOUSEHOLD INCOME FOR SAN JUAN COUNTY IS $46,007.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>PROMOTION OF COMMUNITY HEALTH: IN THE CONSTANT EFFORT TO MEET COMMUNITY NEEDS, SJRMC SEEKS TO IMPROVE PHYSICIAN ACCESS THROUGH A VIGOROUS RECRUITING PROGRAM AND TO PROVIDE COMMUNITY EDUCATION AND MANY OTHER COMMUNITY BENEFIT PROGRAMS. IN FISCAL YEAR 2019, SAN JUAN REGIONAL MEDICAL CENTER PROVIDED BENEFITS TO THE INDIGENT AND BROADER COMMUNITY OF OVER $54,862,649</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>description of Affiliated Healthcare system: The Affiliated Healthcare system includes San Juan Regional Medical Center (SJRMC) and San Juan regional Rehabilitation Hospital (SJRRH). - SJRMC serves the community as the main hospital for the region. - SJRRH serves the community as a rehabilitation hospital.</ExplanationTxt>
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    </IRS990ScheduleH>
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          <BusinessNameLine1Txt>SEXUAL ASSAULT SERVICES</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>622 W MAPLE STE H</AddressLine1Txt>
          <CityNm>FARMINGTON</CityNm>
          <StateAbbreviationCd>NM</StateAbbreviationCd>
          <ZIPCd>87401</ZIPCd>
        </USAddress>
        <RecipientEIN>203187125</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
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        <PurposeOfGrantTxt>program support</PurposeOfGrantTxt>
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        <FormAndLineReferenceDesc>Schedule I, Part I, Question 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Organization's procedures for monitoring the use of grant funds: Event Funding/Sponsorship request guidelines: San Juan Regional Medical Center (SJRMC) recognizes the value of community partnerships and, on a limited basis, offers support to its community partners by sharing our resources including the time and talent of our physicians and employees, as well as our financial and in-kind support. San Juan Regional Medical Center has established criteria to ensure alignment with our mission and to allow us to strategically focus our limited resources in order to maximize their impact. Sponsorship requests are evaluated based on, but not limited to, the following criteria: - alignment with SJRMC's mission to personalize healthcare and create enthusiasm and vitality in healing - alignment and opportunity to promote strategic service lines and business objectives-community and neighborhood development - magnitude of impact and reach (number of individuals served) - depth and breadth of partnership with requesting organization.</ExplanationTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBERT UNDERWOOD</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Rick Wallace</PersonNm>
        <TitleTxt>FORMER - CEO</TitleTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>Supplemental nonqualified plan: San Juan Regional Medical Center (sjrmc) has a 457(F) deferred compensation plan that allows certain executives to contribute money on a pre-tax basis into investments and to accumulate tax-deferred earnings. The following pre-tax calendar year 2017 contributions to the 457(F) plan are included in schedule J, Part II, column (C) as deferred compensation: Karen Miller $13,044 Suzanne Smith $11,454 Jeff Bourgeois $53,215 Ruth Brooks $14,993 Robert Underwood $12,456</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule J, Part I, line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>EXPLANATION OF NON-FIXED PAYMENTS: MANAGEMENT INCENTIVE PLAN- SJRMC HAS A SENIOR MANAGEMENT INCENTIVE COMPENSATION PLAN FOR SELECTED SENIOR MANAGEMENT POSITIONS. AN AWARD TARGET IS ESTABLISHED FOR EACH PARTICIPANT. PERFORMANCE IS BASED ON EIGHT GOALS, TWO OF WHICH ARE HOSPITAL EXCESS OF REVENUES OVER EXPENSES PERCENTAGE AND TOTAL HOSPITAL EARNINGS. THE AWARD IS A PERCENTAGE OF BASE PAY IF CERTAIN TARGETS ARE MET. PHYSICIAN INCENTIVE PLAN- PHYSICIANS INCENTIVES ARE PERFORMANCE BASED AND RELATIVE VALUE UNITS ARE USED AS A MEASURE.</ExplanationTxt>
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          <BusinessNameLine1Txt>CITY FARMINGTON NEW MEXICO</BusinessNameLine1Txt>
        </IssuerName>
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        <CUSIPNum>311428AZ9</CUSIPNum>
        <BondIssuedDt>2004-03-25</BondIssuedDt>
        <IssuePriceAmt>16982883</IssuePriceAmt>
        <PurposeDesc>Construction of Tower/New Equipmen</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CITY FARMINGTON NEW MEXICO</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>856000129</BondIssuerEIN>
        <CUSIPNum>311428BNS</CUSIPNum>
        <BondIssuedDt>2007-06-28</BondIssuedDt>
        <IssuePriceAmt>12290518</IssuePriceAmt>
        <PurposeDesc>Constructions of Cancer Trmt CTR</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>NEW MEXICO HOSPITAL EQUIPMENT LOAN COUNCIL</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>840426875</BondIssuerEIN>
        <BondIssuedDt>2010-12-21</BondIssuedDt>
        <IssuePriceAmt>25773000</IssuePriceAmt>
        <PurposeDesc>Refund 2004B, Finance Equip/Cost</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>9541963</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>17087788</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>339658</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>16748130</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2007</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>5757450</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>12457932</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>151021</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>245810</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>12060921</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2010</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>16200000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>25773063</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>205249</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>10565327</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>15002307</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2011</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>true</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>schedule k, part ii, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXCESS OF THE TOTAL PROCEEDS ON PART II, LINE 3 OVER ISSUE PRICE ON PART I, COLUMN E IS DUE TO INVESTMENT EARNINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>schedule k, part I, LINE C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 2010A LEASE PROJECT OBLIGATION PORTION OF THIS ISSUE IN THE AMOUNT OF $8,103,000 HAS NOT BEEN DESIGNATED AS A QUALIFIED TAX-EXEMPT OBLIGATION. THESE ARE BUILD AMERICA BONDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>schedule k, part IV, LINE 2c, column B</FormAndLineReferenceDesc>
        <ExplanationTxt>The most recent rebate calculation for the 2007A issue was completed on July 19, 2017 for the time period June 28, 2007 to June 28,2017.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Cassie Buffington</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Family Member of Officer</RelationshipDescriptionTxt>
        <TransactionAmt>79981</TransactionAmt>
        <TransactionDesc>employee pay</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Eric buffington</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Family Member of Officer</RelationshipDescriptionTxt>
        <TransactionAmt>316722</TransactionAmt>
        <TransactionDesc>employee pay</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>VOLUNTEERS: SJRMC HAS A TOTAL OF 143 VOLUNTEERS THAT PROVIDE SERVICE TO THE FOLLOWING AREAS: ADMINISTRATIVE SUPPORT, CANCER TREATMENT CENTER, CARDIAC REHABILITATION, COURIER/PATIENT TRANSPORT, CRAFTY CREATIONS, DIETARY, GIFT MARKET, INFORMATION DESK, MAIL CALL, MEDICAL RECORDS AND AUXILIARY MEMBERSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>Program Service cont. San Juan Regional Medical center (SJRMC) is a modern acute-care hospital located in one of the most rural areas of the American southwest, San Juan County, New Mexico. A 2019 ESTIMATE OF THE POPULATION OF SAN JUAN COUNTY SHOWS THECOUNTY POPULATION HAS DECLINED 4.7% FROM THE YEAR 2010 TO 2019 NUMBERING APPROXIMATELY 123,958, 41.1% OF WHICH IS AMERICAN INDIAN AND ALASKA NATIVE PERSONS. SJRMC is a sole community provider and disproportionate share hospital providing needed healthcare to residents of the four corners region of New Mexico, Arizona, Utah and Colorado. San Juan Regional Medical Center's mission is to personalize healthcare and create enthusiasm and vitality in healing. Our core values are actively taught, and reinforced to staff, management, and physicians so that the organization m achieve excellence and consistency in patient care. SJRMC is a community governed hospital that was founded in 1910 by Doctors A M Smith and G W Sammons. The hospital corporation is an advisory body composed of up to three representatives from each of 90 non-profit organizations in San Juan County. The corporation meets quarterly, and at annual meeting, they nominate and elect 9 members to the governing board of directors. The corporation receives reports from the board of directors and hospital administration on hospital operations, including quality and finance and provides feedback on community health issues. SJRMC provides medical, surgical, pediatrics, oncology, obstetrics, cardiology, and behavioral health inpatient care. Ambulatory care includes day surgery, urgent care, outpatient diagnostic and treatment services. SJRMC is a level III trauma center that provides ground ambulance and air ambulance service with a helicopter and a fixed wing aircraft as well as services through its emergency department to all persons regardless of their ability to pay. Some of our outpatient Services are physician clinics specializing in cardiology, behavioral heal internal medicine, neurosurgery, neurodiagnostics, urgent care center and pediatrics. Our financial and in-kind contributions went to various local charities such as Navajo ministries, family crisis center, local school districts, senior centers and Total Behavioral Health. The other community services noted above provide care for surgery, gastrointestinal, orthopedics, oncology, neuro and cardiac rehab.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6 &amp; 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>CLASSES OF MEMBERS OR STOCKHOLDERS: SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) IS A COMMUNITY-GOVERNED HOSPITAL. THE HOSPITAL CORPORATION IS AN ADVISORY BODY COMPOSED OF TWO REPRESENTATIVES FROM ABOUT 90 NON-PROFIT ORGANIZATION MEMBERS IN SAN JUAN COUNTY. AFTER TEN YEARS OF SERVICE AS A REPRESENTATIVE, AN INDIVIDUAL MAY BE DESIGNATED BY THE CORPORATION AS A SENIOR CORPORATE DELEGATE AND SHALL NO LONGER BE CONSIDERED TO BE THE REPRESENTATIVE OF THE MEMBER ORGANIZATION. THE MEMBER ORGANIZATION MAY THEN DESIGNATE ANOTHER REPRESENTATIVE IN ADDITION TO THE SENIOR CORPORATE DELEGATE. THE HOSPITAL CORPORATION MEETS QUARTERLY AT THEIR ANNUAL MEETING, IN WHICH THEY NOMINATE AND ELECT NINE VOTING MEMBERS TO SJRMC'S BOARD OF DIRECTORS. OF THE NINE, THREE MUST BE ELECTED FROM THE MEMBER REPRESENTATIVES OR SENIOR CORPORATE DELEGATES. IN ADDITION TO THE NINE ELECTED DIRECTORS, THE SJRMC CHIEF OF THE STAFF AND VICE CHIEF OF STAFF AND A HOSPITAL AUXILIARY APPOINTEE ALSO SERVE AS SJRMC DIRECTORS FOR A TOTAL OF TWELVE VOTING MEMBERS OF THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM BASED ON DATA PROVIDED BY MANAGEMENT. A DRAFT COPY OF THE 990 IS PROVIDED TO MANAGEMENT FOR REVIEW AND A MEETING IS CONDUCTED BY THE ACCOUNTING FIRM TO REVIEW THE RETURN IN DETAIL. ANY QUESTIONS ARE ADDRESSED AND ANY NECESSARY CHANGES ARE MADE TO THE RETURN. THE FINAL DRAFT OF THE FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE ALONG WITH A BRIEF EDUCATION SESSION CONDUCTED BY THE ACCOUNTING FIRM TO DISCUSS THE HIGHLIGHTS OF THE FORM. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: SAN JUAN REGIONAL MEDICAL CENTER HAS A CONFLICT OF INTEREST POLICY THAT EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE IS REQUIRED TO FILL OUT ON AN ANNUAL BASIS. THIS CONFLICT OF INTEREST POLICY SPECIFICALLY ASKS QUESTIONS REGARDING BUSINESS AND PERSONAL RELATIONSHIPS THAT THEY MAY HAVE WITH ANY OTHER BOARD MEMBER, OFFICER AND KEY EMPLOYEE OF ANY BUSINESS THAT DEALS WITH SAN JUAN REGIONAL MEDICAL CENTER OR ANY OF ITS AFFILIATES. IF A CONFLICT IS IDENTIFIED, IT MUST BE REPORTED TO THE COMPLIANCE OFFICER, AND IF IT CONSTITUTES A BREACH OF EMPLOYMENT, IT MAY LEAD TO DISCIPLINARY ACTION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A &amp; 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIBE PROCESS FOR DETERMINING COMPENSATION: THE BOARD OF DIRECTORS FOR SAN JUAN REGIONAL MEDICAL CENTER USES THE FOLLOWING COMPARABILITY DATA WHEN DETERMINING THE COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT. REGIONAL/LOCAL AREA NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, NATIONAL NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, AND OTHER RELEVANT COMPARATORS (EG, FOR-PROFIT HEALTHCARE AND/OR GENERAL INDUSTRY ORGANIZATIONS) OF COMPARABLE SIZE AND COMPLEXITY. ADDITIONALLY, THE BOARD BI-ANNUALLY HAS AN INDEPENDENT OUTSIDE FIRM COMPARE THE CEO'S, and Other Officer's COMPENSATION WITH OTHER HEALTHCARE ORGANIZATIONS TO REMAIN COMPETITIVE. THE PROCESS WAS LAST COMPLETED IN APRIL 2018 BY TOWERS WATSON. THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES WHEN PRESENTED TO THE INDIVIDUALS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: SAN JUAN REGIONAL MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION REPORTED ON PART VII, LINE 1 FOR DAMON KALCICH IS FROM HIS CURRENT EMPLOYMENT WITH SJRMC, NOT FOR SERVICES RENDERED AS A BOARD MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:MEDICAL PROFESSIONAL FEES TOTAL FEES:8635793</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CALL SERVICES TOTAL FEES:718000</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:191091</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONTRACT &amp; CONSULTING TOTAL FEES:23902089</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:SOBERING HOUSE TOTAL FEES:534767</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:215161</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SAN JUAN HEALTH PARTNERS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>801 WEST MAPLE STREET</AddressLine1Txt>
          <CityNm>FARMINGTON</CityNm>
          <StateAbbreviationCd>NM</StateAbbreviationCd>
          <ZIPCd>87401</ZIPCd>
        </USAddress>
        <EIN>272367549</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NM</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SJRMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SAN JUAN REGIONAL REHABILITATION HOSP</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>525 SOUTH SCHWARTZ AVE</AddressLine1Txt>
          <CityNm>FARMINGTON</CityNm>
          <StateAbbreviationCd>NM</StateAbbreviationCd>
          <ZIPCd>87401</ZIPCd>
        </USAddress>
        <EIN>850441767</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NM</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SJRMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AUXILIARY OF SAN JUAN REGIONAL MED CTR</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>801 WEST MAPLE STREET</AddressLine1Txt>
          <CityNm>FARMINGTON</CityNm>
          <StateAbbreviationCd>NM</StateAbbreviationCd>
          <ZIPCd>87401</ZIPCd>
        </USAddress>
        <EIN>237164296</EIN>
        <PrimaryActivitiesTxt>HOSP SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NM</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12C</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SJR HOLDING COMPANY INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>801 W MAPLE STREET</AddressLine1Txt>
          <CityNm>FARMINGTON</CityNm>
          <StateAbbreviationCd>NM</StateAbbreviationCd>
          <ZIPCd>87401</ZIPCd>
        </USAddress>
        <EIN>201126483</EIN>
        <PrimaryActivitiesTxt>SUPPORT SERVI</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NM</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SJRMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C-CORP</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>1617847</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>3683294</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>true</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>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SAN JUAN REGIONAL REHABILITATION HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>525130</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>interco amount</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SAN JUAN REGIONAL REHABILITATION HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>144000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>interco amount</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SJR Holding Company INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>1420993</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERCO AMOUNT</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>