﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2024v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2026-01-07T10:19:46-05:00</ReturnTs>
    <TaxPeriodEndDt>2025-03-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>010440155</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>RUNYON KERSTEEN OUELLETTE</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>20 LONG CREEK DR</AddressLine1Txt>
        <CityNm>SOUTH PORTLAND</CityNm>
        <StateAbbreviationCd>ME</StateAbbreviationCd>
        <ZIPCd>04106</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-04-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>237423047</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>DFD RUSSELL MEDICAL CENTER INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>DFDR</BusinessNameControlTxt>
      <PhoneNum>2075243501</PhoneNum>
      <USAddress>
        <AddressLine1Txt>180 CHURCH HILL ROAD</AddressLine1Txt>
        <CityNm>LEEDS</CityNm>
        <StateAbbreviationCd>ME</StateAbbreviationCd>
        <ZIPCd>04263</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MICHELE TANGUAY</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>2075244004</PhoneNum>
      <SignatureDt>2026-01-06</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>AMY CHASSE</PreparerPersonNm>
      <PTIN>P00967183</PTIN>
      <PhoneNum>2077732986</PhoneNum>
      <PreparationDt>2026-01-06</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc5">
      <PrincipalOfficerNm>LAURIE KANE-LEWIS</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>180 CHURCH HILL ROAD</AddressLine1Txt>
        <CityNm>LEEDS</CityNm>
        <StateAbbreviationCd>ME</StateAbbreviationCd>
        <ZIPCd>04263</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>10792851</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.DFDRUSSELL.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1975</FormationYr>
      <LegalDomicileStateCd>ME</LegalDomicileStateCd>
      <ActivityOrMissionDesc>THE MISSION OF DFD RUSSELL MEDICAL CENTER IS TO ENSURE THAT EVERYONE IN OUR COMMUNITIES HAVE ACCESS TO, AND ARE PROVIDED WITH, THE HIGHEST QUALITY PRIMARY HEALTH CARE, REGARDLESS OF ABILITY TO PAY.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>6</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>6</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>130</TotalEmployeeCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>2442723</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>2375939</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>7998196</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>8401045</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>12302</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>12342</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>604</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>3525</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>10453825</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>10792851</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>8050081</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>8181560</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>2450196</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>2766569</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>10500277</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>10948129</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-46452</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-155278</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>7000266</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>6734662</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>3254346</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>3148173</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>3745920</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>3586489</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>THE MISSION OF DFD RUSSELL MEDICAL CENTER IS TO ENSURE THAT EVERYONE IN OUR COMMUNITIES HAVE ACCESS TO, AND ARE PROVIDED WITH, THE HIGHEST QUALITY PRIMARY HEALTH CARE, REGARDLESS OF ABILITY TO PAY.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>8378976</ExpenseAmt>
      <RevenueAmt>8401045</RevenueAmt>
      <Desc>DFD RUSSELL MEDICAL CENTER (DFD RMC) IS A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER. AS SUCH IT PROVIDES A RANGE OF SERVICES FOR RESIDENTS OF WESTERN AND CENTRAL MAINE FROM SITES IN THE TOWNS OF LEEDS, MONMOUTH, BRIDGTON, AND TURNER. DURING THE TAX YEAR, DFD RMC PROVIDED 26,849 MEDICAL ENCOUNTERS, 4,951 BEHAVIORAL HEALTH ENCOUNTERS, AND 59 DENTAL HYGIENE ENCOUNTERS TO A TOTAL OF 9,060 MEDICAL PATIENTS, 914 BEHAVIORAL HEALTH PATIENTS, AND 56 DENTAL HYGIENE PATIENTS. 30% OF THESE PATIENTS HAD INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINE.</Desc>
      <TotalProgramServiceExpensesAmt>8378976</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc6">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc3">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc3">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc3">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc3">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc3">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc3">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc3">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc3">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc3">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc3">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc3">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc3">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc3">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc4">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>13</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>130</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>6</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>6</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>MICHELE TANGUAY</PersonNm>
        <PhoneNum>2075244004</PhoneNum>
        <USAddress>
          <AddressLine1Txt>180 CHURCH HILL ROAD SUITE 1</AddressLine1Txt>
          <CityNm>LEEDS</CityNm>
          <StateAbbreviationCd>ME</StateAbbreviationCd>
          <ZIPCd>04263</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>THERESA GILLIS</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL EATON</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DALE HINDS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY DOUGHERTY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WES WISSE</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 LEE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURIE KANE-LEWIS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>223614</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29368</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHELE TANGUAY</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>102061</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19710</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY RIVARD DO</PersonNm>
        <TitleTxt>MEDICAL DIRE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>314051</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45674</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LESLIE BRADBURY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>250121</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28033</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTOPHER BUTLER</PersonNm>
        <TitleTxt>NURSE PRACTI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>124041</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36807</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HEATHER ERRINGTON</PersonNm>
        <TitleTxt>NURSE PRACTI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>122910</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27499</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TRISHA GUSHUE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>252466</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33051</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURIE HUNTRESS</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>255007</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43389</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER MICHAUD</PersonNm>
        <TitleTxt>NURSE PRACTI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>122378</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15566</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHANIE PRATT</PersonNm>
        <TitleTxt>COORDINATOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>102988</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16932</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIDGET ROSS-FITZGIBBONS</PersonNm>
        <TitleTxt>NURSE PRACTI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>123335</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15628</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLEY STANLEY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>251808</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43260</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LYDIA THORP</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>266847</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43799</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2511627</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>398716</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>16</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>H3C LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2909 N 118TH ST STE 120</AddressLine1Txt>
            <CityNm>OMAHA</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68164</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CCM</ServicesDesc>
        <CompensationAmt>176167</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>2375939</GovernmentGrantsAmt>
      <TotalContributionsAmt>2375939</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICES</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>6605265</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6605265</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PHARMACY PROGRAM</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>1380226</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1380226</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>QUALITY INITIATIVES</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>415554</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>415554</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>8401045</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>12342</TotalRevenueColumnAmt>
        <ExclusionAmt>12342</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>3525</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3525</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>3525</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>10792851</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8404570</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>12342</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>939998</TotalAmt>
        <ProgramServicesAmt>225868</ProgramServicesAmt>
        <ManagementAndGeneralAmt>714130</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>5654186</TotalAmt>
        <ProgramServicesAmt>5335436</ProgramServicesAmt>
        <ManagementAndGeneralAmt>318750</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>161282</TotalAmt>
        <ProgramServicesAmt>155993</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5289</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>945666</TotalAmt>
        <ProgramServicesAmt>853791</ProgramServicesAmt>
        <ManagementAndGeneralAmt>91875</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>480428</TotalAmt>
        <ProgramServicesAmt>405861</ProgramServicesAmt>
        <ManagementAndGeneralAmt>74567</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>28934</TotalAmt>
        <ManagementAndGeneralAmt>28934</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>24531</TotalAmt>
        <ManagementAndGeneralAmt>24531</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>463980</TotalAmt>
        <ProgramServicesAmt>265297</ProgramServicesAmt>
        <ManagementAndGeneralAmt>198683</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>57481</TotalAmt>
        <ManagementAndGeneralAmt>57481</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>225869</TotalAmt>
        <ProgramServicesAmt>8941</ProgramServicesAmt>
        <ManagementAndGeneralAmt>216928</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>352922</TotalAmt>
        <ProgramServicesAmt>170695</ProgramServicesAmt>
        <ManagementAndGeneralAmt>182227</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>164399</TotalAmt>
        <ManagementAndGeneralAmt>164399</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>4030</TotalAmt>
        <ManagementAndGeneralAmt>4030</ManagementAndGeneralAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>340581</TotalAmt>
        <ProgramServicesAmt>23610</ProgramServicesAmt>
        <ManagementAndGeneralAmt>316971</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>44728</TotalAmt>
        <ManagementAndGeneralAmt>44728</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>COST OF SALES - 340B PROG</Desc>
        <TotalAmt>554413</TotalAmt>
        <ProgramServicesAmt>554413</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>226198</TotalAmt>
        <ProgramServicesAmt>188976</ProgramServicesAmt>
        <ManagementAndGeneralAmt>37222</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MAINTENANCE &amp; REPAIRS</Desc>
        <TotalAmt>74697</TotalAmt>
        <ProgramServicesAmt>4700</ProgramServicesAmt>
        <ManagementAndGeneralAmt>69997</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EDUCATION</Desc>
        <TotalAmt>67118</TotalAmt>
        <ProgramServicesAmt>65658</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1460</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>136688</TotalAmt>
        <ProgramServicesAmt>119737</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16951</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>10948129</TotalAmt>
        <ProgramServicesAmt>8378976</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2569153</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>38559</BOYAmt>
        <EOYAmt>20169</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1065174</BOYAmt>
        <EOYAmt>1367642</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>929751</BOYAmt>
        <EOYAmt>685828</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>15853</BOYAmt>
        <EOYAmt>8076</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>225851</BOYAmt>
        <EOYAmt>255918</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>7660315</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3484750</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>4375818</BOYAmt>
        <EOYAmt>4175565</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>349260</BOYAmt>
        <EOYAmt>221464</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>7000266</BOYAmt>
        <EOYAmt>6734662</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>694533</BOYAmt>
        <EOYAmt>776921</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>9184</BOYAmt>
        <EOYAmt>6932</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>2240545</BOYAmt>
        <EOYAmt>2170726</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>310084</BOYAmt>
        <EOYAmt>193594</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3254346</BOYAmt>
        <EOYAmt>3148173</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>3745920</BOYAmt>
        <EOYAmt>3586489</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>3745920</BOYAmt>
        <EOYAmt>3586489</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>7000266</BOYAmt>
        <EOYAmt>6734662</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-155278</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-4153</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc6">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>3191356</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3229079</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3187074</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2442723</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2375939</CurrentTaxYearAmt>
        <TotalAmt>14426171</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>4877619</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>6555246</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7110678</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7998800</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>8404570</CurrentTaxYearAmt>
        <TotalAmt>34946913</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>8068975</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9784325</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10297752</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10441523</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10780509</CurrentTaxYearAmt>
        <TotalAmt>49373084</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>3073087</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2847408</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2891507</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1938392</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2054940</CurrentTaxYearAmt>
        <TotalAmt>12805334</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>3073087</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2847408</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2891507</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1938392</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2054940</CurrentTaxYearAmt>
        <TotalAmt>12805334</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>36567750</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>4305</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2955</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8908</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12302</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12342</CurrentTaxYearAmt>
        <TotalAmt>40812</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>4305</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2955</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8908</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12302</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12342</CurrentTaxYearAmt>
        <TotalAmt>40812</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>8073280</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9787280</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10306660</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10453825</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10792851</CurrentTaxYearAmt>
        <TotalAmt>49413896</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.74000</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.72190</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <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="RetDoc3">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>190619</OtherCostOrOtherBasisAmt>
        <BookValueAmt>190619</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>5954481</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2329051</DepreciationAmt>
        <BookValueAmt>3625430</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1515215</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1155699</DepreciationAmt>
        <BookValueAmt>359516</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>4175565</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>RIGHT OF USE LIABILITY - OPERATING</Desc>
        <Amt>193594</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>193594</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>10788698</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-4153</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-4153</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>10792851</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>10792851</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>10948129</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>10948129</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>10948129</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE AND STATE TAXING AUTHORITIES. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc4">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LAURIE KANE-LEWIS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>223614</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9079</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>20289</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>252982</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GARY RIVARD DO</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>314051</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>12595</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>33079</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>359725</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LESLIE BRADBURY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>250121</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8890</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>19143</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>278154</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTOPHER BUTLER</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>124041</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>3728</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>33079</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>160848</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HEATHER ERRINGTON</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>122910</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>4554</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22945</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>150409</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TRISHA GUSHUE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>252466</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10106</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22945</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>285517</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LAURIE HUNTRESS</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>255007</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10310</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>33079</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>298396</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KELLEY STANLEY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>251808</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10181</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>33079</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>295068</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LYDIA THORP</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>266847</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10720</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>33079</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>310646</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS PROVIDED TO THE FULL BOARD OF DIRECTORS BEFORE IT IS FILED AND IS REVIEWED BY THE FINANCE COMMITTEE PRIOR TO THAT MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OF THE BOARD AND THE SENIOR MANAGEMENT MUST REVIEW THEIR INDIVIDUAL CONFLICT OF INTEREST DOCUMENT ON AN ANNUAL BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION FOR THE CEO IS REVIEWED AND APPROVED BY THE FULL BOARD DURING AN EXECUTIVE SESSION. THE REVIEW INCLUDES COMPARATIVE DATA FOR BOTH THE REGION AND THE NATION FOR CEO'S IN ORGANIZATIONS OF SIMILAR PURPOSE, SCOPE, AND SIZE. THE MEETING IS DOCUMENTED IN MINUTES AND THE DECISION FORWARDED DIRECTLY BY THE PRESIDENT TO THE CHIEF FINANCIAL OFFICER FOR IMPLEMENTATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>NACHC AND OTHER HEALTH CENTERS ARE QUERIED FOR THE SALARIES OF THE CFO, DIRECTOR OF CLINICAL QUALITY, AND MEDICAL DIRECTOR. SALARIES ARE PAID BASED UPON THE PREVAILING MARKET FOR ALL CLINICIANS, AND SALARY SURVEYS (MGMA, MPCA, AND NACHC) ARE LOOKED AT AND RECRUITING FIRMS ARE USED AS A RESOURCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>