﻿<?xml version="1.0" encoding="utf-8"?>
<Return xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2016v3.0" xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2017-09-26T12:26:29-05:00</ReturnTs>
    <TaxPeriodEndDt>2016-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>911194016</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CLARK NUBER PS</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>10900 NE 4TH STREET SUITE 1700</AddressLine1Txt>
        <CityNm>BELLEVUE</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98004</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2016-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>911939741</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>TRAUMA TRUST</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>TRAU</BusinessNameControlTxt>
      <PhoneNum>2534037537</PhoneNum>
      <USAddress>
        <AddressLine1Txt>315 MARTIN LUTHER KING JR WAY</AddressLine1Txt>
        <CityNm>TACOMA</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98405</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>CAESAR URSIC MD</PersonNm>
      <PersonTitleTxt>MEDICAL DIRECTOR</PersonTitleTxt>
      <PhoneNum>2534037537</PhoneNum>
      <SignatureDt>2017-09-19</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>MEGAN RYAN</PreparerPersonNm>
      <PTIN>P00737884</PTIN>
      <PhoneNum>4254544919</PhoneNum>
      <PreparationDt>2017-09-20</PreparationDt>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>65.158.230.202</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2017-09-19</IPDt>
      <IPTm>21:01:19</IPTm>
      <IPTimezoneCd>PD</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>EE9472A6866F5D2CC65667176191C38BB98995E0</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>C070BA3AF7F6D7D87E83B9D9DF9412DF7C2C6F3F</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2016</TaxYr>
    <BuildTS>2021-01-29 14:40:06Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>CAESAR URSIC MD</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>315 MARTIN LUTHER KING JR WAY</AddressLine1Txt>
        <CityNm>TACOMA</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98405</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>4919385</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.TACOMATRAUMA.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1998</FormationYr>
      <LegalDomicileStateCd>WA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROVIDE EXPERT CARE IN TRAUMA, EMERGENCY GENERAL SURGERY AND SURGICAL CRITICAL CARE.</ActivityOrMissionDesc>
      <ContractTerminationInd>X</ContractTerminationInd>
      <VotingMembersGoverningBodyCnt>12</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>12</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>44</TotalEmployeeCnt>
      <TotalVolunteersCnt>14</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>170669</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>214885</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>4414976</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>4525425</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1470</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>132</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>34193</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>178943</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>4621308</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>4919385</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>7296079</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>8347195</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>3052854</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>3660410</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>10348933</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>12007605</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-5727625</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-7088220</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>1578939</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>1352693</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>908787</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>1019273</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>670152</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>333420</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TRAUMA TRUST'S MISSION IS TO PROVIDE EXPERT COMPREHENSIVE CARE IN TRAUMA, EMERGENCY GENERAL SURGERY AND SURGICAL CRITICAL CARE IN THE SOUTH PUGET SOUND AND THE WEST REGION.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>11349803</ExpenseAmt>
      <RevenueAmt>4525925</RevenueAmt>
      <Desc>TRAUMA TRUST CONTINUES TO PROVIDE ADULT TRAUMA CARE TO THE TACOMA/SOUTH SOUND AREA WHICH SERVES AS A VALUABLE RESOURCE FOR THE WEST REGIONS AND OTHER SURROUNDING TRAUMA CENTERS CARING FOR PATIENTS WITH COMPLEX ORTHOPEDIC, CHEST, ABDOMINAL, FACIAL, HEAD AND SPINE INJURIES. TRAUMA TRUST HAS SERVED 27,770 TRAUMA PATIENTS SINCE ITS INCEPTION IN 2000 WHICH INCLUDES 2,363 TRAUMA PATIENTS BEING SEEN IN 2016 (AN INCREASE FROM 2015 WHERE 2,286 WERE SEEN).THE TRAUMA TRUST IS COMPRISED OF TRAUMA SURGEONS THAT ARE SUPPORTED BYPHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS. DUE TO A NECESSITY FOR24/7 COVERAGE FOR EMERGENCY SURGERY IN 2009 THE GROUP EXPANDED ITSSERVICE TO INCLUDE ACUTE CARE SURGICAL SERVICES (ACSS). THIS EXPANSIONHAS IMPROVED THROUGHPUT, STANDARDIZED CARE AND ALLOWS FOR A TEAMAPPROACH. THE ACSS HAS SEEN A RAPID INCREASE IN PATIENT VOLUME WHICHHAS DOUBLED THE NUMBER OF PATIENTS SEEN BY TRAUMA TRUST PROVIDERS.TRAUMA TRUST PROVIDES EDUCATIONAL OPPORTUNITIES FOR RESIDENT ANDPHYSICIAN ASSISTANT STUDENTS INCLUDING MADIGAN ARMY MEDICAL CETNER (MAMC) AND NAVY PERSONNEL. WE HAVE APPROXIMATELY 15-20 ROTATIONS PER YEAR THROUGH OUR SERVICE THAT ALLOWS FOR MONITORED HANDS-ON CARE OF TRAUMA AND SURGICAL PATIENTS.TRAUMA TRUST SUPPORTS THE WEST REGION BY SERVING AS A RESOURCE ANDPROVIDING EDUCATION TO SURROUNDING TRAUMA CENTERS AND EMERGENCY MEDICALSERVICES (EMS). TRAUMA TRUST ATTENDS AND HOSTS EVENTS AND PROVIDESEDUCATION AND FEEDBACK ON THE STANDARDS OF THE CRITICALLY INJUREDPATIENT. TRAUMA TRUST ALSO HAS REPRESENTATION ON THE WASHINGTON STATETRAUMA AND EMERGENCY SERVICES COMMITTEE AND CHAIRS THE TRAUMA MEDICAL DIRECTOR TECHNICAL ADVISORY COMMITTEE.EDUCATIONONE OF OUR LARGER EDUCATION PROJECTS IS IN NOVEMBER EACH YEAR. TRAUMA TRUST HOSTS THE TACOMA TRAUMA CONFERENCE AT THE GREATER TACOMA CONVENTION &amp; TRADE CENTER. EACH YEAR WE PARTNER WITH DIFFERENT ORGANIZATIONS TO ENRICH OUR CONFERENCE OFFERINGS. IN 2016, WE PARTNERED WITH THE MAMC'S ANDERSON SIMULATION CENTER WHO UTILIZED BOTH MILITARY AND CIVILIAN PERSONNEL TO PUT ON A MOCK BOMBING MASS CASUALTY SCENARIO THAT CONFERENCE PARTICIPANTS TOOK AN ACTIVE PART IN. THE CONFERENCE COVERS TOPICS IN BOTH ADULT &amp; PEDIATRIC TRAUMA AND IS TAILORED TO NURSES &amp; PARAMEDICS AS WELL AS ADVANCED PRACTITIONERS AND PHYSICIANS. IN 2016, TRAUMA TRUST PROVIDED 10 SCHOLARSHIPS TO STUDENTS WISHING TO ATTEND THE CONFERENCE. IN 2016 THE CONFERENCE WAS ATTENDED BY 332 PAID ATTENDEES. THE STRENGTH OF THE TRAUMA TEAM COULDN'T BE POSSIBLE WITHOUT THE EXCELLENT CARE PROVIDED BY THE PRE-HOSPITAL (EMS) PROVIDERS AND THE NURSES. TRAUMA TRUST PROVIDES EDUCATION TO EMS AND NURSING UNITS TO ENHANCE CARE PROVIDED. IN 2016 WE SPOKE TO SEVERAL EMS GROUPS ON FALLS AND TRAUMATIC BRAIN INJURY (TBI), GERIATRIC UNDER-TRIAGE AND THORACIC TRAUMA. WE PROVIDED EDUCATION ON CERVICAL SPINE AND ORTHOPEDIC INJURY CARE TO THE ORTHO NURSING UNITS AT SJMC AND WE PROVIDED TRAUMA SKILLS EDUCATION TO BOTH TG AND SJMC EMERGENCY DEPARTMENT NURSES. WE ARE ALSO ACTIVE IN THE TRAUMA COMPETENCY GROUPS FOR BOTH FACILITIES. WE STARTED IN LATE 2016 ON PLANS FOR GRAND ROUNDS TO PROVIDE FREE EDUCATION CEU'S FOR OUR EMS, MEDICAL AND HOSPITAL STAFF IN 2017.TRAUMA TRUST HAS UPDATED THEIR WEBSITE THAT WE SHARE WITH THE COMMUNITY AND WE HAVE ADDED NEW OUTREACH PROGRAMS AND ARE ADDING MORE FREE TRAUMA EDUCATION IN THE FORM OF LEARNING MODULES TO HELP NURSING STAFF KEEP UP TO DATE WITH TRAUMA CARE. WE ARE SETTING UP TWO NEW FREE PROGRAMS FOR THE COMMUNITY AVAILABLE IN 2017. INJURY PREVENTIONINJURY PREVENTION IS A CORE COMPONENT OF EVERY TRAUMA PROGRAM. TRAUMATRUST WORKS CLOSELY WITH THE PIERCE COUNTY FALLS PREVENTION COALITION(PCFPC) TO INCREASE AWARENESS OF FALLS AND PROMOTE PREVENTION TOCOMMUNITY DWELLING SENIORS. WITH THE COLLABORATION OF TRAUMA TRUST,PCFPC WAS AWARDED A GRANT OF $2,300 TO BE USED TO ERECT SAIL SIGNS INTWO PARKS, ONE IN PUYALLUP AND ONE IN FIRCREST. THE PURPOSE OF THESIGNS IS TO GET SENIORS OUT WALKING AND DOING STRENGTH EXERCISES.STUDIES SHOW THAT THE BEST WAY TO PREVENT FALLS IS TO KEEP ACTIVE AND KEEP STRENGTH.TRAUMA TRUST HAS PROVIDED FALL PREVENTION/HEAD INJURY EDUCATION TOSEVERAL SENIOR COMMUNITY CENTERS THAT WAS VERY WELL RECEIVED.</Desc>
      <TotalProgramServiceExpensesAmt>11349803</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc1040000001">0</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">0</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd>0</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd referenceDocumentId="RetDoc1043200001">0</TerminateOperationsInd>
      <PartialLiquidationInd referenceDocumentId="RetDoc1043200001">1</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>7</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>44</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>12</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>12</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>0</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>0</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>KAREN DONJEE</PersonNm>
        <PhoneNum>2534034570</PhoneNum>
        <USAddress>
          <AddressLine1Txt>315 MARTIN LUTHER KING JR WAY</AddressLine1Txt>
          <CityNm>TACOMA</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>98405</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM CAMMARANO</PersonNm>
        <TitleTxt>BOARD CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHELLY MULLIN RN MHA</PersonNm>
        <TitleTxt>BOARD VICE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DIANE CECCHETTINI RN</PersonNm>
        <TitleTxt>SECRETARY/TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SYD BERSANTE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEVE LITSKY MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MAGGIE BAKER RN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAUL MATTHEWS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRUE DAMMEIER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AARON LAIRD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL NEWHOUSE EMT-P</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CYNDE RIVERS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BILL ROBERTSON</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK ADAMS MD</PersonNm>
        <TitleTxt>BOARD MEMBER (THRU 3/2016)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GRAHAM HUNT</PersonNm>
        <TitleTxt>BOARD MEMBER (THRU 2/2016)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CAESAR URSIC MD</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>557207</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>60071</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERESA BELL MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>442325</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23850</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID PATTERSON MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>411811</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>53802</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AML RAAFAT MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>406730</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>62823</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS FERRER MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>401207</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42766</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA SCHOMOGYI</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>363591</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>56532</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAUL INOUYE</PersonNm>
        <TitleTxt>FORMER OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>167537</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25398</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2750408</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>325242</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>27</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PROLIANCE SURGEONS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>7308 BRIDGEPORT WAY W SUITE 201</AddressLine1Txt>
            <CityNm>LAKEWOOD</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98499</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACTED ORTHOPEDIC SURGEONS</ServicesDesc>
        <CompensationAmt>369750</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PARS PLASTIC SURGERY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1708 SOUTH YAKIMA AVENUE SUITE 11</AddressLine1Txt>
            <CityNm>TACOMA</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98405</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACTED PLASTIC SURGEON</ServicesDesc>
        <CompensationAmt>199704</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>2</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>177635</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>37250</AllOtherContributionsAmt>
      <TotalContributionsAmt>214885</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICES</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>4036816</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4036816</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CALL BURDEN</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>431200</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>431200</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONFERENCE FEES</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>50909</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>50909</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>STUDENT ROTATIONS</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>6500</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6500</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>4525425</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>132</TotalRevenueColumnAmt>
        <ExclusionAmt>132</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>SECURITY DEPOSIT REFUN</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>160947</TotalRevenueColumnAmt>
        <ExclusionAmt>160947</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>INSURANCE REBATE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>9243</TotalRevenueColumnAmt>
        <ExclusionAmt>9243</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>PEER REVIEW STIPEND</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>7000</TotalRevenueColumnAmt>
        <ExclusionAmt>7000</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>1753</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>500</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>1253</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>178943</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>4919385</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4525925</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>178575</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>589007</TotalAmt>
        <ProgramServicesAmt>589007</ProgramServicesAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6351517</TotalAmt>
        <ProgramServicesAmt>6216173</ProgramServicesAmt>
        <ManagementAndGeneralAmt>135344</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>574396</TotalAmt>
        <ProgramServicesAmt>562973</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11423</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>453598</TotalAmt>
        <ProgramServicesAmt>433698</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19900</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>378677</TotalAmt>
        <ProgramServicesAmt>378677</ProgramServicesAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>57227</TotalAmt>
        <ManagementAndGeneralAmt>57227</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>32023</TotalAmt>
        <ManagementAndGeneralAmt>32023</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1671650</TotalAmt>
        <ProgramServicesAmt>1651544</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20106</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>28009</TotalAmt>
        <ProgramServicesAmt>4805</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23204</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>8514</TotalAmt>
        <ManagementAndGeneralAmt>8514</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <TravelGrp>
        <TotalAmt>40855</TotalAmt>
        <ManagementAndGeneralAmt>40855</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>63328</TotalAmt>
        <ProgramServicesAmt>63328</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InsuranceGrp>
        <TotalAmt>415735</TotalAmt>
        <ProgramServicesAmt>401684</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14051</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>892813</TotalAmt>
        <ProgramServicesAmt>892813</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BILLING FEES</Desc>
        <TotalAmt>233574</TotalAmt>
        <ManagementAndGeneralAmt>233574</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>B &amp; O TAXES</Desc>
        <TotalAmt>135950</TotalAmt>
        <ProgramServicesAmt>135950</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EMPLOYEE RETENTION</Desc>
        <TotalAmt>49161</TotalAmt>
        <ManagementAndGeneralAmt>49161</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>31571</TotalAmt>
        <ProgramServicesAmt>19151</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12420</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>12007605</TotalAmt>
        <ProgramServicesAmt>11349803</ProgramServicesAmt>
        <ManagementAndGeneralAmt>657802</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>72282</BOYAmt>
        <EOYAmt>171522</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>374326</BOYAmt>
        <EOYAmt>144418</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1010112</BOYAmt>
        <EOYAmt>896473</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>122219</BOYAmt>
        <EOYAmt>140280</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <TotalAssetsGrp>
        <BOYAmt>1578939</BOYAmt>
        <EOYAmt>1352693</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>341240</BOYAmt>
        <EOYAmt>411220</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>567547</BOYAmt>
        <EOYAmt>608053</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>908787</BOYAmt>
        <EOYAmt>1019273</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>670152</BOYAmt>
        <EOYAmt>333420</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>670152</BOYAmt>
        <EOYAmt>333420</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>1578939</BOYAmt>
        <EOYAmt>1352693</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-7088220</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>6751488</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>277502</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>210365</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>133611</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>170669</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>214885</CurrentTaxYearAmt>
        <TotalAmt>1007032</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>5357446</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4154428</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4817606</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4414976</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4525425</CurrentTaxYearAmt>
        <TotalAmt>23269881</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>5634948</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4364793</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4951217</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4585645</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4740310</CurrentTaxYearAmt>
        <TotalAmt>24276913</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>24276913</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>1217</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4755</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3464</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1470</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>132</CurrentTaxYearAmt>
        <TotalAmt>11038</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>1217</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4755</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3464</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1470</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>132</CurrentTaxYearAmt>
        <TotalAmt>11038</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus3YearsAmt>23284</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9830</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>34193</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>178943</CurrentTaxYearAmt>
        <TotalAmt>246250</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>5636165</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4392832</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4964511</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4621308</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4919385</CurrentTaxYearAmt>
        <TotalAmt>24534201</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98950</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99680</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00040</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00050</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>ADMIN FEES - 2013 AMOUNT: $ 9,000. TESTIMONY FEES - 2013 AMOUNT: $ 14,243. 2014 AMOUNT: $ 3,950. 2015 AMOUNT: $ 14,655. 2016 AMOUNT: $ 500. MISCELLANEOUS - 2013 AMOUNT: $ 41. 2015 AMOUNT: $ 24. 2016 AMOUNT: $ 1,253. TRAINING FEES - 2014 AMOUNT: $ 5,880. INSURANCE PROCEEDS - 2015 AMOUNT: $ 10,000. MALPRACTICE DIVIDEND - 2015 AMOUNT: $ 9,514. REBATES AND REFUNDS - 2016 AMOUNT: $ 170,190. PEER STIPEND REVIEW - 2016 AMOUNT: $ 7,000.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <TotalBookValueLandBuildingsAmt>0</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>SETTLEMENTS RESERVE</Desc>
        <Amt>1857</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>RETIREMENT PLAN CONTRIBUTION PAYABLE</Desc>
        <Amt>606196</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>608053</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>4306648</TotalRevEtcAuditedFinclStmtAmt>
      <DonatedServicesAndUseFcltsAmt>280076</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>-892813</OtherRevenueAmt>
      <RevenueNotReportedAmt>-612737</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>4919385</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>4919385</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>11394868</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>280076</DonatedServicesUseFcltsAmt>
      <ExpensesNotReportedAmt>280076</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>11114792</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>892813</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>892813</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>12007605</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE -892,813.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE 892,813.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CAESAR URSIC MD</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>490364</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>66843</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>31800</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28271</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>617278</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TERESA BELL MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>442325</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>23850</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>466175</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID PATTERSON MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>365364</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>46447</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>31800</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22002</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>465613</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AML RAAFAT MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>361782</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>44948</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>31800</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>31023</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>469553</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS FERRER MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>365364</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>35843</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>31800</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10966</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>443973</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LISA SCHOMOGYI</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>308000</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>55591</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>31800</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24732</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>420123</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL INOUYE</PersonNm>
        <TitleTxt>FORMER OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>154577</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>12960</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14965</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10433</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>192935</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleN documentId="RetDoc1043200001">
      <DispositionOfAssetsDetail>
        <AssetsDistriOrExpnssPaidDesc>ORDINARY OPERATING EXPENSES</AssetsDistriOrExpnssPaidDesc>
        <FairMarketValueOfAssetAmt>12007605</FairMarketValueOfAssetAmt>
      </DispositionOfAssetsDetail>
      <DirectorOfSuccessor2Ind>0</DirectorOfSuccessor2Ind>
      <EmployeeOfSuccessor2Ind>0</EmployeeOfSuccessor2Ind>
      <OwnerOfSuccessor2Ind>0</OwnerOfSuccessor2Ind>
      <ReceiveCompensation2Ind>0</ReceiveCompensation2Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS CONTINUING ALL OPERATIONS. IT IS NOT DISSOLVING OR OTHERWISE CEASING ANY ACTIVITIES OR OPERATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleN>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NUMBER OF VOLUNTEERS WAS DETERMINED BY THE NUMBER OF NON-PAID BOARD MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE ARE FOUR CORPORATE MEMBERS: CATHOLIC HEALTH INITIATIVES, MULTICARE HEALTH SYSTEM, MADIGAN ARMY MEDICAL CENTER, AND PIERCE COUNTY MEDICAL SOCIETY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE IS ONE CLASS OF MEMBER. MEMBERS HAVE THE POWER TO ELECT, APPOINT OR REMOVE ANY MEMBER OF ANY BOARD COMMITTEE OR ANY DIRECTOR OR OFFICER OF THE CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>CORPORATE MEMBERS HAVE THE POWER TO AMEND, ALTER OR REPEAL THE BYLAWS AND ARTICLES OF INCORPORATION. MEMBERS ALSO HAVE THE POWER TO AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR ADOPT A PLAN FOR DISTRIBUTION OF THE ASSETS OF THE CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990 WAS DISBURSED TO EVERYONE ON THE BOARD OF DIRECTORS AND THEY ALL HAD THE OPPORTUNITY TO REVIEW, ASK QUESTIONS, AND PROVIDE INPUT BEFORE IT WAS SUBMITTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL EMPLOYEES AND MEMBERS OF THE BOARD ARE RESPONSIBLE FOR READING AND UNDERSTANDING THE CONFLICT OF INTEREST POLICY. THE GOVERNING BODY EXAMINES ANY PENDING CONFLICTS OF INTEREST AT ANNUAL BOARD MEETINGS. WHEN A CONFLICT OF INTEREST ARISES, OR WHEN A POTENTIAL CONFLICT OF INTEREST EMERGES, BOARD MEMBERS ARE REQUIRED TO DISCLOSE THAT CONFLICT, OR POTENTIAL CONFLICT, TO THE DIRECTOR OF TRAUMA TRUST OR TO THE CHAIRMAN OF ITS BOARD OF DIRECTORS AND SEEK RESOLUTION OF THAT ISSUE. IN ALL MATTERS THAT COME BEFORE THE BOARD OF DIRECTORS FOR A VOTE THAT MAY FAVORABLY IMPACT THE FINANCIAL INTEREST OF A BOARD MEMBER, OR THE PRIVATE INTEREST OF OTHERS WITH WHOM THEY HAVE A FINANCIAL RELATIONSHIP, MEMBERS ARE REQUIRED TO REVEAL THAT RELATIONSHIP AND ABSTAIN FROM A VOTE IN THE MATTER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>TOP MANAGEMENT OFFICIALS OF MULTICARE HEALTH SYSTEM AND FRANCISCAN HEALTH SYSTEM AUTHORIZE COMPENSATION FOR OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE DATE OF THE LAST COMPENSATION REVIEW WAS IN DECEMBER 2016.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINES 13 &amp; 14:</FormAndLineReferenceDesc>
        <ExplanationTxt>TRAUMA TRUST RELIES ON THE WHISTLEBLOWER POLICY AND THE DOCUMENT RETENTION AND DESTRUCTION POLICY OF MULTICARE HEALTH SYSTEM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CALL BURDEN PAYMENTS TO CONTRACTED SURGEONS: PROGRAM SERVICE EXPENSES 431,200. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 431,200. MEDICAL OPINION/CHART REVIEW: PROGRAM SERVICE EXPENSES 990,560. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 990,560. CONTRACTED SUBSPECIALTY: PROGRAM SERVICE EXPENSES 73,097. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,097. EMPLOYEE BENEFIT MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 16,600. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,600. PROFESSIONAL FEES - OTHER: PROGRAM SERVICE EXPENSES 156,687. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 156,687. PAYROLL PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,506. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,506.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBER CAPITAL CONTRIBUTIONS 6,751,488.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>