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        <RegionTotalExpendituresAmt>1038</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>Russia and Neighboring States</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Program Services</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>SALE OF BOOKS</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>600</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>0</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>0</SubtotalEmployeesCnt>
      <ContinutationTotalOfficeCnt>0</ContinutationTotalOfficeCnt>
      <ContinutationTotalEmployeeCnt>0</ContinutationTotalEmployeeCnt>
      <TotalOfficeCnt>0</TotalOfficeCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <SubtotalSpentAmt>35320522</SubtotalSpentAmt>
      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>35320522</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="15000238" softwareVersionNum="2015v2.1">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Health Research and Educational Trust</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>155 N Wacker Drive</AddressLine1Txt>
          <CityNm>Chicago</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60606</ZIPCd>
        </USAddress>
        <RecipientEIN>362203931</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>1822524</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Institute for Diversity in Health Management</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>155 N Wacker Drive</AddressLine1Txt>
          <CityNm>Chicago</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60606</ZIPCd>
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        <RecipientEIN>582094118</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>707000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ST FRANCIS HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>100 PORT WASHINGTON BLVD</AddressLine1Txt>
          <CityNm>ROSLYN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>11576</ZIPCd>
        </USAddress>
        <RecipientEIN>112050523</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>40000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNIVERSITY OF WISCONSIN MADISON</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3130 ENGINEERING CENTERS BLDG</AddressLine1Txt>
          <CityNm>MADISON</CityNm>
          <StateAbbreviationCd>WI</StateAbbreviationCd>
          <ZIPCd>53706</ZIPCd>
        </USAddress>
        <RecipientEIN>396006492</RecipientEIN>
        <IRCSectionDesc>gov't</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>RESEARCH GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>B'NAI B'RITH INTERNATIONAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3397 Barham Blvd</AddressLine1Txt>
          <CityNm>Los Angeles</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>90068</ZIPCd>
        </USAddress>
        <RecipientEIN>530179971</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>7500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ALLIANCE FOR HEALTH REFORM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1444 Eye Street NW</AddressLine1Txt>
          <CityNm>Washington</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
        </USAddress>
        <RecipientEIN>521746328</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASAE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1575 I Street NW</AddressLine1Txt>
          <CityNm>Washington</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
        </USAddress>
        <RecipientEIN>521300485</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>8500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BALDRIGE FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4925 Greenville</AddressLine1Txt>
          <CityNm>Dallas</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75206</ZIPCd>
        </USAddress>
        <RecipientEIN>201806185</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>125000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>NATIONAL COALITION ON HEALTH CARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1120 G Street NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
        </USAddress>
        <RecipientEIN>521687849</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>100000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PROJECT PERFECT WORLD Foundation</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>290 East John Carpenter Freeway</AddressLine1Txt>
          <CityNm>Irving</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75062</ZIPCd>
        </USAddress>
        <RecipientEIN>043546835</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>40000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>THE SCHWARTZ CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 417597</AddressLine1Txt>
          <CityNm>BOSTON</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02241</ZIPCd>
        </USAddress>
        <RecipientEIN>041564655</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SOUTH CAROLINA HOSPITAL RESEARCH &amp; EDUCATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1000 CENTER POINT ROAD</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>SC</StateAbbreviationCd>
          <ZIPCd>29210</ZIPCd>
        </USAddress>
        <RecipientEIN>576026361</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>DISASTER RELIEF</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CENTER FOR HEALTH DESIGN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1850 Gateway Blvd</AddressLine1Txt>
          <CityNm>Concord</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>94520</ZIPCd>
        </USAddress>
        <RecipientEIN>680298038</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNITED WAY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>560 West Lake Street</AddressLine1Txt>
          <CityNm>Chicago</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60661</ZIPCd>
        </USAddress>
        <RecipientEIN>300200078</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>14000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
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      <RecipientTable>
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          <BusinessNameLine1Txt>NATIONAL PATIENT SAFETY FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>268 SUMMER ST</AddressLine1Txt>
          <CityNm>BOSTON</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02210</ZIPCd>
        </USAddress>
        <RecipientEIN>367166993</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ANTI DEFAMATION LEAGUE FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1100 CONNECTICUT AVE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20036</ZIPCd>
        </USAddress>
        <RecipientEIN>132887439</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ENVIRONMENTAL HEALTH &amp; SAFETY SOLUTIONS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1702</AddressLine1Txt>
          <CityNm>DISCOVERY BAY</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>94505</ZIPCd>
        </USAddress>
        <RecipientEIN>453418525</RecipientEIN>
        <CashGrantAmt>13890</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>RESEARCH GRANT</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>COALITION TO TRANSFORM ADVANCED CARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1299 PENNSYLVANIA AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20004</ZIPCd>
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        <RecipientEIN>452604332</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT PAYMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>AMERICAN RED CROSS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2200 WEST HARRISON STREET</AddressLine1Txt>
          <CityNm>CHICAGO</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60612</ZIPCd>
        </USAddress>
        <RecipientEIN>530196605</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>DISASTER RELIEF</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>18</Total501c3OrgCnt>
      <TotalOtherOrgCnt>1</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>ASHE INTERNSHIP GRANT</GrantTypeTxt>
        <RecipientCnt>3</RecipientCnt>
        <CashGrantAmt>11000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>n/a</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>n/a</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>ILSE ALMANZA SCHOLARSHIP</GrantTypeTxt>
        <RecipientCnt>12</RecipientCnt>
        <CashGrantAmt>24000</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 ASHE INTERNSHIP PROGRAM'S PURPOSE IS TO PROVIDE AN OPPORTUNITY FOR A UNIVERSITY STUDENT INTERN TO GAIN VALUABLE EXPERIENCE IN MANAGING THE HEALTH CARE FACILITY PHYSICAL ENVIRONMENT. 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>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
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      <HousingAllowanceOrResidenceInd>X</HousingAllowanceOrResidenceInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
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      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>165023</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Neil J Jesuele</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>AHA EVP</TitleTxt>
        <BaseCompensationFilingOrgAmt>716588</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>61539</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>743115</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>196513</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24760</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1742514</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>509682</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>R John Evans</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP/CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>303685</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>32658</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>284167</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>71213</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>34641</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>726364</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>158550</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Michael P Guerin</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP GOV EXEC</TitleTxt>
        <BaseCompensationFilingOrgAmt>154460</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationFilingOrgAmt>81306</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>39241</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15386</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>318663</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Gail M Lovinger</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>VP SECRETARY</TitleTxt>
        <BaseCompensationFilingOrgAmt>240948</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>15900</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>23155</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>304872</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Barbara Lorsbach</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP MEMBER RELATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>248584</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <NontaxableBenefitsFilingOrgAmt>19752</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>445811</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>74321</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Lisa M Allen</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP CHIEF HR OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>297777</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>506040</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>43377</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Jack A MacKay</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>VP/CIO</TitleTxt>
        <BaseCompensationFilingOrgAmt>291892</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <NontaxableBenefitsFilingOrgAmt>22887</NontaxableBenefitsFilingOrgAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dale L Woodin</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SR ED-INFRASTRUCTURE</TitleTxt>
        <BaseCompensationFilingOrgAmt>211574</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>264911</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Eileen O'Keefe</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Acting Sr Exec Memb Rel</TitleTxt>
        <BaseCompensationFilingOrgAmt>290456</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>344124</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Amy Mosser</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>HF COO-VP AHA License Dev</TitleTxt>
        <BaseCompensationFilingOrgAmt>258923</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>320823</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>John R Combes</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP AHA &amp; COO CHG</TitleTxt>
        <BaseCompensationFilingOrgAmt>403430</BaseCompensationFilingOrgAmt>
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        <TotalCompensationFilingOrgAmt>696394</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Thomas P Nickels</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP FED RELATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>577472</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Melinda R Hatton</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP &amp; GENERAL COUNSEL</TitleTxt>
        <BaseCompensationFilingOrgAmt>479295</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Linda E Fishman</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP POLICY</TitleTxt>
        <BaseCompensationFilingOrgAmt>277081</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>470550</TotalCompensationFilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Alicia N Mitchell</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>SVP COMMUNICATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>292872</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>29561</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>96865</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>68682</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13316</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>501297</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>46405</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <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 and three officers. 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 and nineteen Board members in 2015. 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 five officers, two key employees, and five of the highest compensated employees. The related benefit was included in the interest 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 2015. The related benefit was included in taxable compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>The following officers, key employees and highest compensated employees participated in or received payment from a supplemental nonqualified retirement plan: -Richard Umbdenstock - $338,653 -Neil Jesuele - $676,641 -Richard Pollack - $165,023 -Michael Guerin - $26,882 -Richard Evans - $211,691 -Barbara Lorsbach - $74,321 -Lisa Allen - $43,377 -Thomas Nickels - $118,715 -Linda Fishman - $45,238 -Melinda Hatton - $72,916 -John Combes - $67,788 -Alicia Mitchell - $46,405</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="15000238" softwareVersionNum="2015v2.1">
      <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 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>
      </SupplementalInformationDetail>
      <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>
      </SupplementalInformationDetail>
      <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, Human Resources and Internal Audit. 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>
      </SupplementalInformationDetail>
      <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 REVENUE - Total Revenue: 109342, Related or Exempt Function Revenue: 109342, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 11d Other Miscellaneous Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Revenue - Total Revenue: 232362, Related or Exempt Function Revenue: 232362, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>pension liability adjustment - -640408;</ExplanationTxt>
      </SupplementalInformationDetail>
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