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        <ExplanationTxt>AHA RECEIVED CONTRIBUTIONS FROM AHA EMPLOYEES IN SUPPORT OF AHAPAC. THE FUNDS FROM AHA EMPLOYEES WERE RECEIVED AND DIRECTLY DELIVERED TO AHAPAC, A RELATED TAX-EXEMPT SECTION 527 POLITICAL ORGANIZATION.</ExplanationTxt>
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        <ExplanationTxt>The Association is exempt from federal income taxes under Section 501(c)(6) of the Internal Revenue Code. The Association follows the provisions of the Accounting for Uncertainty in Income Taxes section of the Income Taxes Topic of the ASC, which addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under this guidance, the Association may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities, based on the technical merits of the position. Examples of tax positions include the tax-exempt status of the Association and various positions related to the potential sources of unrelated business taxable income (UBTI). The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate settlement. There were no unrecognized tax benefits identified and recorded as liabilities for the reporting periods presented herein. The Association files Form 990 in the U.S. Federal jurisdiction, the State of Illinois, and other jurisdictions as required. The AHAPAC files a form 1120-POL. The Association's Form 990 includes HF LLC as a disregarded entity.</ExplanationTxt>
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        <TypeOfActivitiesConductedTxt>Investments</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>N/A</SpecificServicesProvidedTxt>
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      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>Sub-Saharan Africa</RegionTxt>
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        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Program Services</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>SALES OF BOOKS AND DATA.</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>10</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>0</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>0</SubtotalEmployeesCnt>
      <ContinuationTotalOfficeCnt>0</ContinuationTotalOfficeCnt>
      <ContinuationTotalEmployeeCnt>0</ContinuationTotalEmployeeCnt>
      <TotalOfficeCnt>0</TotalOfficeCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <SubtotalSpentAmt>37216385</SubtotalSpentAmt>
      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>37216385</TotalSpentAmt>
      <TransferToForeignCorpInd>true</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>false</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>true</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>true</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>true</ForeignPartnershipInd>
      <BoycottCountriesInd>true</BoycottCountriesInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule F, Part I, Line 3 INFORMATION ON ACTIVITIES OUTSIDE THE UNITED STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S FOREIGN ACTIVITIES CONSIST MAINLY OF SALES OF BOOKS AND DATA PRODUCTS IN FOREIGN COUNTRIES WHICH GENERATE REVENUE. THE ORGANIZATION DOES NOT SEPARATELY TRACK EXPENDITURES RELATED TO THE SALE OF BOOKS AND DATA TO FOREIGN COUNTRIES. ADDITIONALLY, THE ORGANIZATION HAS A LIMITED AMOUNT EXPENSES RELATED TO FOREIGN TRAVEL FOR ATTENDING CONFERENCES AND MEETINGS WITH OTHER ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleI documentId="IRS990ScheduleI" softwareId="18007697" softwareVersionNum="2018v3.1">
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        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>155 N WACKER DRIVE</AddressLine1Txt>
          <CityNm>CHICAGO</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60606</ZIPCd>
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        <RecipientEIN>362203931</RecipientEIN>
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        </RecipientBusinessName>
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          <AddressLine1Txt>155 N WACKER DRIVE</AddressLine1Txt>
          <CityNm>CHICAGO</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60606</ZIPCd>
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        <RecipientEIN>582094118</RecipientEIN>
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      <RecipientTable>
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          <BusinessNameLine1Txt>COALITION TO TRANSFORM ADVANCED CARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
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          <AddressLine1Txt>1299 PENNSYLVANIA AVE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
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          <BusinessNameLine1Txt>NATIONAL ACADEMY OF SCIENCES</BusinessNameLine1Txt>
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          <CityNm>ALEXANDRIA</CityNm>
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          <CityNm>ROCKVILLE</CityNm>
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          <CityNm>CONCORD</CityNm>
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        </RecipientBusinessName>
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          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
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        </RecipientBusinessName>
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          <CityNm>IRVING</CityNm>
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          <CityNm>Sacramento</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
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          <CityNm>WASHINGTON</CityNm>
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          <CityNm>TALLAHASSEE</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>32301</ZIPCd>
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          <BusinessNameLine1Txt>DAVID A WINSTON BALL</BusinessNameLine1Txt>
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          <AddressLine1Txt>1341 G STREET NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
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        <CashGrantAmt>12000</CashGrantAmt>
        <PurposeOfGrantTxt>support payment</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>HOPE FOR THE DAY</BusinessNameLine1Txt>
        </RecipientBusinessName>
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          <CityNm>CHICAGO</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60657</ZIPCd>
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          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
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          <CityNm>WASHINGTON</CityNm>
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          <CityNm>SAN FERNANDO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
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          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20036</ZIPCd>
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          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
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        <CashGrantAmt>10000</CashGrantAmt>
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        </RecipientBusinessName>
        <USAddress>
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          <CityNm>CARY</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27513</ZIPCd>
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          <CityNm>MCLEAN</CityNm>
          <StateAbbreviationCd>VA</StateAbbreviationCd>
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          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20036</ZIPCd>
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          <BusinessNameLine1Txt>AMERICAN COLLEGE OF HEALTHCARE ARCHITECTS</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>4400 COLLEGE BLVD</AddressLine1Txt>
          <CityNm>OVERLAND PARK</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66211</ZIPCd>
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          <BusinessNameLine1Txt>COALITION TO PROTECT AMERICA'S HEALTHCARE</BusinessNameLine1Txt>
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        <USAddress>
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          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
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        <GrantTypeTxt>ILSE ALMANZA SCHOLARSHIP</GrantTypeTxt>
        <RecipientCnt>181</RecipientCnt>
        <CashGrantAmt>262850</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part III GRANTS TO INDIVIDUALS</FormAndLineReferenceDesc>
        <ExplanationTxt>The Ilse B. Almanza Scholarship supports education and training to develop future leaders committed to optimizing the health care physical environment.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.</FormAndLineReferenceDesc>
        <ExplanationTxt>Typically AHA makes grants and contributions to organizations to support their general operations or in response to their fundraising efforts. In these instances, AHA does not have a formal process for which they monitor the use of the grant paid. In other cases, the AHA provides grants or contributions to support a specific effort or project. In such cases, AHA's management is kept informed as to the use of the funds and the status or satisfactory completion of the project.</ExplanationTxt>
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    </IRS990ScheduleI>
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          <BusinessNameLine1Txt>Gloria J Kupferman</BusinessNameLine1Txt>
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        <TitleTxt>Chief Data Strategy Offic</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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          <BusinessNameLine1Txt>Henrietta S Fielek</BusinessNameLine1Txt>
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        <TitleTxt>VP Political Outreach</TitleTxt>
        <BaseCompensationFilingOrgAmt>296784</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a First-class or charter travel</FormAndLineReferenceDesc>
        <ExplanationTxt>By policy, First-class travel was made available to three Board members, CEO and two Executive Vice Presidents in 2018. It was not treated as taxable compensation for any interested person. These individuals are required to travel extensively on organization business, and providing for first-class travel is considered a reasonable accommodation. Additionally, first-class travel may be approved in cases of hardship or extenuating circumstances on a case-by-case basis.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a Travel for companions</FormAndLineReferenceDesc>
        <ExplanationTxt>Spousal travel was provided to three officers, CEO and two Executive Vice Presidents in 2018. The related benefit was included in the interested persons' taxable compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a Discretionary spending account</FormAndLineReferenceDesc>
        <ExplanationTxt>In connection with official duties, stipends were made available to the Chairman, Immediate Past Chairman, and Chairman Elect of the Board. Taxable benefit allowances were made available to Senior Vice President's and above. The related benefit was included in the interested persons' taxable compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a Housing allowance or residence for personal use</FormAndLineReferenceDesc>
        <ExplanationTxt>A housing allowance was provided to one key employee in 2018. The related benefit was included in taxable compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4a Severance or change-of-control payment</FormAndLineReferenceDesc>
        <ExplanationTxt>The following officers, key employees and highest compensated employees received severance: -R. John Evans - $350,055 -John R. Combes - $357,169 -Ryan Frazier - $339,464 -Jack Mackay - $126,752 -Eileen O'Keefe - $100,633</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING THE 2018 CALENDAR YEAR, AMERICAN HOSPITAL ASSOCIATION (AHA) MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: - RICHARD J. POLLACK - MARY JANE WURTH - CHRISTINA FISHER - DOUGLAS C. SHAW - THOMAS P. NICKELS - MELINDA R. HATTON - ALICIA N. MITCHELL - ASHLEY THOMPSON - GAIL M. LOVINGER - SUSAN GERGELY - LISA M. ALLEN - RYAN FRAZIER DURING 2018, THE FOLLOWING CONTRIBUTIONS WERE MADE BY AHA TO THE PLAN: - RICHARD J. POLLACK: $429,415 - MARYJANE WURTH: $182,093 - CHRISTINA FISHER: $71,185 - DOUGLAS C. SHAW: $39,648 - THOMAS P. NICKELS: $184,654 - MELINDA R. HATTON: $100,182 - ALICIA N. MITCHELL: $65,288 - ASHLEY THOMPSON: $72,543 - GAIL M. LOVINGER: $43,293 - SUSAN GERGELY: $28,528 DURING 2018, THE FOLLOWING DISTRIBUTIONS WERE MADE BY AHA FROM THE PLAN: - RICHARD J. POLLACK: $232,428 - LISA M. ALLEN: $51,079 - THOMAS P. NICKELS: $184,654 - MELINDA R. HATTON: $100,182 - ALICIA N. MITCHELL: $52,905 - ASHLEY THOMPSON: $10,226</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="18007697" softwareVersionNum="2018v3.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES</FormAndLineReferenceDesc>
        <ExplanationTxt>WHERE APPROPRIATE, THE COMMITTEE HAS AUTHORIZED THE CEO TO APPLY THE SAME PROCEDURES AS DESCRIBED IN THE NARRATIVE FOR PART VI, SECTION B, LINE 15A TO THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES. FOR ALL OTHER OFFICERS AND KEY EMPLOYEES, COMPENSATION IS EVALUATED BY THE ORGANIZATION'S MANAGEMENT ON AN ANNUAL BASIS USING PERFORMANCE AGAINST ANNUAL PERFORMANCE GOALS. PLEASE SEE THE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1a Delegate broad authority to a committee</FormAndLineReferenceDesc>
        <ExplanationTxt>There shall be an Executive Committee of the Board of Trustees composed of the chair of the Board of Trustees, the chair-elect of the Board of Trustees, the immediate past chair of the Board of Trustees, the president, and the chair of the Operations Committee, all of whom shall be ex officio members with the power to vote, and such additional members of the Board of Trustees as recommended by the Executive Committee and appointed by the Board of Trustees. The Executive Committee shall have the power to act on behalf of the Board of Trustees between meetings of the Board of Trustees when, in the judgment of the committee, it is necessary.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>AHA is organized as a not-for-profit corporation with members. These members may participate in the organization's governance. Specifically, members may participate in the election of members of the governing body. The membership of AHA is made up of: 1. Hospitals, health care systems, and health service organizations which provide a continuum of integrated community health resources and which include at least one licensed hospital that is owned, leased, managed or religiously sponsored. 2. Health provider organizations, other than registered hospitals, which provide patient care services, as well as physician groups, health insurance services, and staff and group model health maintenance organizations without a hospital component. 3. Other organizations interested in the objectives of the association. 4. Personal members. Members of the Board of Trustees are selected by a Committee on Nominations. Members who seek to be on the Board are put through a vetting process, and a slate of candidates is presented to the Board for approval.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>Please see the narrative for Part VI, Section A, Line 6.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>The full Form 990 is reviewed by management and by legal counsel. It is then reviewed by the Board of Trustees Operations Committee, the Board of Trustees Executive Committee, and finally the entire Board of Trustees prior to filing with the IRS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>On an annual basis, the Association's trustees are required to read, complete and return a conflict of interest questionnaire to the association secretary. The Association's officers, key employees and all other employees are required to read, complete and return a conflict of interest questionnaire on an annual basis. The returned questionnaires are handled jointly by the Secretary, Legal, Compliance, and Human Resources. Any questionnaire that raises a potential issue is reviewed and referred to the Association's President for determination regarding a conflict and any action to be considered or undertaken. Any potential conflict of interest that arises after the questionnaire is completed must be promptly reported. Any restrictions imposed, based on information disclosed in a conflict of interest questionnaire or otherwise, would be commensurate with the type of conflict identified and would be disclosed to the Board of Trustees.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS DOES NOT INCLUDE ANY INDIVIDUAL WHOSE COMPENSATION IT REVIEWS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT TO PRODUCE COMPARABLE SALARY DATA FOR THE CEO, AND OFFICERS AND KEY EMPLOYEES AS APPROPRIATE, AND MAKES RECOMMENDATIONS FOR COMPENSATION ADJUSTMENTS, CONSISTENT WITH EXISTING COMPENSATION AGREEMENTS, POLICIES AND PROCEDURES. THE COMMITTEE CONSIDERS THE RECOMMENDATIONS FROM THE COMPENSATION CONSULTANT, EVALUATES THE CEO'S PERFORMANCE AGAINST ANNUAL PERFORMANCE GOALS, AND DETERMINES WHETHER ANY ADJUSTMENT OR PERFORMANCE-BASED REWARD SHOULD BE MADE. The process for determining, reviewing and approving compensation and adjustments to compensation is undertaken on an annual basis. CONTEMPORANEOUS MINUTES OF THE COMMITTEE'S DELIBERATIONS AND DECISIONS ARE PREPARED AND REVIEWED BY THE COMMITTEE IN A TIMELY MANNER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents and conflict of interest policy are available upon request to members; a summary of the financial results are printed each year as part of the annual report to membership. Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 2f Other Program Service Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>Other - Total Revenue: 346818, Related or Exempt Function Revenue: 346818, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;</ExplanationTxt>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>INSTITUTE FOR DIVERSITY IN HEALTH MANAGEMENT</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>99531</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>cost</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>