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        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>170871</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13808</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ISAAC SAUCEDO</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>236047</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29532</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH SANTARSIERI</PersonNm>
        <TitleTxt>CHIROPRACTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>174091</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20203</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KENNETH MURPHY</PersonNm>
        <TitleTxt>PA</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>159087</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8825</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHEN PRIFTAKIS</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>241624</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29485</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1791316</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>161335</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>18</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BARTON &amp; ASSOCIATES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>300 JUBILEE DR</AddressLine1Txt>
            <CityNm>PEABODY</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01960</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL CONTRACTOR SERVICE</ServicesDesc>
        <CompensationAmt>459032</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>IRIS TELEHEALTH MEDICAL GROUP PA</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>114 W 7TH ST STE 650</AddressLine1Txt>
            <CityNm>AUSTIN</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>78701</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>BH CONTRACTOR SERVICES</ServicesDesc>
        <CompensationAmt>431831</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CREST INSURANCE GROUP LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5285 E WILLIAMS CIR STE 4500</AddressLine1Txt>
            <CityNm>TUCSON</CityNm>
            <StateAbbreviationCd>AZ</StateAbbreviationCd>
            <ZIPCd>85711</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>INSURANCE BROKER</ServicesDesc>
        <CompensationAmt>232087</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ECLINICALWORKS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2 TECHNOLOGY DR</AddressLine1Txt>
            <CityNm>WESTBOROUGH</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01581</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EMR SOFTWARE VENDOR</ServicesDesc>
        <CompensationAmt>221416</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NEW MEXICO CARE PARTNERS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4206 LOUISIANA BLVD NE</AddressLine1Txt>
            <CityNm>ALBUQUERQUE</CityNm>
            <StateAbbreviationCd>NM</StateAbbreviationCd>
            <ZIPCd>87109</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>VALUE BASED CARE MSO</ServicesDesc>
        <CompensationAmt>201808</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>12</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>5149148</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>268799</AllOtherContributionsAmt>
      <TotalContributionsAmt>5417947</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>13573277</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13573277</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>680469</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>680469</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>STATE FUNDED PATIENT REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>400768</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>400768</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PHARMACY</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>152958</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>152958</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>14807472</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>143713</TotalRevenueColumnAmt>
        <ExclusionAmt>143713</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>4500</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>4500</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>4500</TotalRevenueColumnAmt>
        <ExclusionAmt>4500</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>20373632</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>14807472</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>148213</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>900400</TotalAmt>
        <ProgramServicesAmt>101045</ProgramServicesAmt>
        <ManagementAndGeneralAmt>799355</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>12631896</TotalAmt>
        <ProgramServicesAmt>8315983</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4315913</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>198874</TotalAmt>
        <ProgramServicesAmt>131570</ProgramServicesAmt>
        <ManagementAndGeneralAmt>67304</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1045209</TotalAmt>
        <ProgramServicesAmt>643125</ProgramServicesAmt>
        <ManagementAndGeneralAmt>402084</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1000803</TotalAmt>
        <ProgramServicesAmt>600166</ProgramServicesAmt>
        <ManagementAndGeneralAmt>400637</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>96150</TotalAmt>
        <ManagementAndGeneralAmt>96150</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>85550</TotalAmt>
        <ManagementAndGeneralAmt>85550</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2152431</TotalAmt>
        <ProgramServicesAmt>1400294</ProgramServicesAmt>
        <ManagementAndGeneralAmt>752137</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>33859</TotalAmt>
        <ManagementAndGeneralAmt>33859</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1840088</TotalAmt>
        <ProgramServicesAmt>832716</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1007372</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>497457</TotalAmt>
        <ManagementAndGeneralAmt>497457</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>324741</TotalAmt>
        <ProgramServicesAmt>280779</ProgramServicesAmt>
        <ManagementAndGeneralAmt>43962</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>128850</TotalAmt>
        <ProgramServicesAmt>58310</ProgramServicesAmt>
        <ManagementAndGeneralAmt>70540</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>159390</TotalAmt>
        <ProgramServicesAmt>72131</ProgramServicesAmt>
        <ManagementAndGeneralAmt>87259</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>2320</TotalAmt>
        <ManagementAndGeneralAmt>2320</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>497261</TotalAmt>
        <ProgramServicesAmt>408994</ProgramServicesAmt>
        <ManagementAndGeneralAmt>88267</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>258213</TotalAmt>
        <ProgramServicesAmt>116852</ProgramServicesAmt>
        <ManagementAndGeneralAmt>141361</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES &amp; DRUG</Desc>
        <TotalAmt>475575</TotalAmt>
        <ProgramServicesAmt>475575</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>431951</TotalAmt>
        <ProgramServicesAmt>431951</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS EXPENSES</Desc>
        <TotalAmt>367578</TotalAmt>
        <ProgramServicesAmt>156401</ProgramServicesAmt>
        <ManagementAndGeneralAmt>211177</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES, DUES &amp; SUBSCR</Desc>
        <TotalAmt>293115</TotalAmt>
        <ProgramServicesAmt>132647</ProgramServicesAmt>
        <ManagementAndGeneralAmt>160468</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>22035</TotalAmt>
        <ManagementAndGeneralAmt>22035</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>23443746</TotalAmt>
        <ProgramServicesAmt>14158539</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9285207</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>418006</BOYAmt>
        <EOYAmt>1298992</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>8210930</BOYAmt>
        <EOYAmt>8229552</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>6839943</BOYAmt>
        <EOYAmt>2449513</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1413389</BOYAmt>
        <EOYAmt>1691107</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>185355</BOYAmt>
        <EOYAmt>1028856</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>17294927</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>6894376</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>10825218</BOYAmt>
        <EOYAmt>10400551</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>220158</BOYAmt>
        <EOYAmt>246827</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>8293</BOYAmt>
        <EOYAmt>8292</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>443109</BOYAmt>
        <EOYAmt>258472</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>28564401</BOYAmt>
        <EOYAmt>25612162</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2189514</BOYAmt>
        <EOYAmt>1819187</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <EOYAmt>700758</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>461667</BOYAmt>
        <EOYAmt>249111</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>2651181</BOYAmt>
        <EOYAmt>2769056</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>25913220</BOYAmt>
        <EOYAmt>22843106</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>25913220</BOYAmt>
        <EOYAmt>22843106</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>28564401</BOYAmt>
        <EOYAmt>25612162</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-3070114</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
    </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>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>3328</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>3328</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER LOBBYING ACTIVITY: DONATION TO GRANT COUNTY PROSPECTORS AND DUES PAID TO NACHC AND NMPCA. A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>38020</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>694699</OtherCostOrOtherBasisAmt>
        <BookValueAmt>732719</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>12951258</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4141913</DepreciationAmt>
        <BookValueAmt>8809345</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1171800</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>475856</DepreciationAmt>
        <BookValueAmt>695944</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>2439150</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2276607</DepreciationAmt>
        <BookValueAmt>162543</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>10400551</TotalBookValueLandBuildingsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>20131240</TotalRevEtcAuditedFinclStmtAmt>
      <DonatedServicesAndUseFcltsAmt>189559</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>-431951</OtherRevenueAmt>
      <RevenueNotReportedAmt>-242392</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>20373632</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>20373632</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>23201354</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>189559</DonatedServicesUseFcltsAmt>
      <ExpensesNotReportedAmt>189559</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>23011795</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>431951</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>431951</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>23443746</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVISION FOR UNCOLLECTIBLE ACCOUNTS -431,951.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVISION FOR UNCOLLECTIBLE ACCOUNTS 431,951.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <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>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TERESA ARIZAGA MD</PersonNm>
        <TitleTxt>CBHO</TitleTxt>
        <BaseCompensationFilingOrgAmt>301194</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9300</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16775</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>327269</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAN OTERO</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9240</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>17065</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>325523</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEPHEN PRIFTAKIS</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>237716</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>3908</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7466</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22019</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>271109</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ISAAC SAUCEDO</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <BaseCompensationFilingOrgAmt>236047</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7311</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22221</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>265579</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GRETCHEN CANNON</PersonNm>
        <TitleTxt>CFO/CIO</TitleTxt>
        <BaseCompensationFilingOrgAmt>209184</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6277</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>825</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>216286</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOSEPH SANTARSIERI</PersonNm>
        <TitleTxt>CHIROPRACTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>158141</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>15950</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5641</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14562</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>194294</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALANDRAH BAILEY</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>166246</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>4625</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5252</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8556</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>184679</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KENNETH MURPHY</PersonNm>
        <TitleTxt>PA</TitleTxt>
        <BaseCompensationFilingOrgAmt>133168</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>13308</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>12611</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8825</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>167912</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>IN ADDITION TO BASE COMPENSATION, PROVIDERS ARE ELIGIBLE TO RECEIVE PERFORMANCE BONUS COMPENSATION BASED ON MEETING A LIST OF ESTABLISHED GOALS AND INITIAITVES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIMARY HEALTH CARE SERVICES: HMS EMPLOYS BOARD-ELIGIBLE AND CERTIFIED FAMILY PRACTICE PHYSICIANS, CERTIFIED PHYSICIANS ASSISTANTS AND FAMILY NURSE PRACTITIONERS TO SERVE OUR PATIENTS. HMS ALSO PROVIDES THE FOLLOWING ANCILLARY SERVICES: LABORATORY SERVICES - LABORATORY SERVICES ARE REGULATED BY MEDICARE THROUGH THE CLINICAL LABORATORY IMPROVEMENT ACT (CLIA). AT RURAL LOCATIONS, HMS OFFERS CLIA WAIVED LAB SERVICES WHICH ARE A LIMITED AND DEFINED SET OF LAB SERVICES THAT CAN BE IN-HOUSE. FOR OTHER TESTS, HMS PROVIDES MODERATE COMPLEXITY LAB SERVICES AT ITS CLINIC IN SILVER CITY. THE MAJORITY OF LAB SERVICES CAN BE PROVIDED WITHIN HMS, WHICH CAN SPEED UP THE RESULTS PROCESS AND PROVIDE BETTER PATIENT CARE. SOME INSURANCE COMPANIES REQUIRE THAT CERTAIN LABS BE SENT TO CERTAIN LABORATORIES IN ALBUQUERQUE OR ELSEWHERE, FOR WHICH HMS WILL MAKE ARRANGEMENTS. HMS ALSO PARTNERS WITH GILA REGIONAL MEDICAL CENTER (GRMC) IN SILVER CITY FOR MORE COMPLICATED LAB PROCESSES. X-RAY SERVICES - BASIC X-RAY SERVICES ARE PROVIDED AT HMS LOCATIONS IN SILVER CITY AND LORDSBURG. ALL OTHER RADIOLOGIC OR OTHER PROCEDURES SUCH AS MAGNETIC RESONANCE IMAGING (MRI) ARE TYPICALLY REFERRED TO GRMC. PATIENT CHOICE IS ALWAYS A CONSIDERATION. PHARMACY - THERE ARE THREE WAYS THAT HMS CAN ASSIST PATIENTS WITH PHARMACY SERVICES BEYOND THE SIMPLE PRESCRIPTION. 1. MEDICATION ASSISTANCE PROGRAM: MANY PHARMACEUTICAL COMPANIES OFFER FREE MEDICATIONS TYPICALLY TO CHRONICALLY ILL PATIENTS WHO QUALIFY FINANCIALLY. THE HMS FAMILY SUPPORT PROGRAM ASSISTS ALL PEOPLE WHO QUALIFY WITH THIS SERVICE, WHETHER THEY ARE HMS PATIENTS OR NOT. THE FAMILY SUPPORT MEDICATION ASSISTANCE PROGRAM (MAP) IS ALSO SUPPORTED BY A NUMBER OF COMMUNITY VOLUNTEERS. 2. 340B PRESCRIPTIONS: HMS HAS ACCESS TO A LIMITED NUMBER OF PRESCRIPTIONS THROUGH THE 340B PROGRAM IN GRANT COUNTY WITH WALGREENS PHARMACY, WAL-MART AND CVS AND THE GENOA PHARMACY IN GRANT AND HIDALGO COUNTIES. THE PROGRAM ALLOWS HMS TO PURCHASE MEDICATIONS AT FEDERAL DRUG PRICES, REDUCING THE PATIENT'S COST. THE PATIENT MUST BE A PATIENT OF HMS, REFERRED ONLY BY HMS PROVIDERS AND BE ELIGIBLE TO THE HMS SLIDING SCALE PROGRAM. 3. EMERGENCY COVERAGE IN HIDALGO COUNTY: HMS COLLABORATES WITH THE HIDALGO COUNTY AMBULANCE SERVICE FOR EMERGENCY SERVICE NEEDS. THE CLINIC IN LORDSBURG WILL SEE MINOR EMERGENCIES, E.G. SUTURES (STITCHES AND BREAKS). FOR GRANT COUNTY PATIENTS, HMS UTILIZES LOCAL AMBULANCE SERVICES FOR EMERGENCIES. HMS PROVIDERS HAVE AN AFTER-HOURS LAB CALL, AND HMS HAS AN AFTER-HOURS NURSE LINE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>BEHAVIORAL HEALTH SERVICES: INTEGRATED BEHAVIORAL HEALTH CARE: BEHAVIORAL HEALTH PROFESSIONALS ARE AVAILABLE TO ASSIST PRIMARY CARE PROVIDERS IDENTIFY AND APPROPRIATELY RESPOND TO EMOTIONAL, BEHAVIORAL AND MENTAL FACTORS THAT IMPACT THE MEDICAL CARE OF PATIENTS. THIS ALLOWS BEHAVIORAL HEALTH PROVIDERS TO SEE PATIENTS IN THE EXAM ROOM IN ORDER TO MAKE A QUICK ASSESSMENT AND PROVIDE A BRIEF, SUPPORTIVE INTERVENTION OR A REFERRAL TO COUNSELING OR PSYCHOTHERAPY SERVICES, EITHER WITHIN HMS OR TO ONE OF THE OTHER AGENCIES PROVIDING A DIFFERENT LEVEL OF CARE WITHIN THE COMMUNITY. QUALIFIED BEHAVIORAL HEALTH PROVIDERS (E.G. PSYCHIATRIC NURSE PRACTITIONERS) MAY ALSO CONSULT WITH PRIMARY CARE PROVIDERS ON APPROPRIATE MEDICATIONS FOR THE PRESENTING CONCERNS. THE GOAL OF THE BEHAVIORAL HEALTH CARE CONSULT ARE BOTH TO ENSURE THE PROPER, CULTURALLY COMPETENT STRATEGY FOR HEALTH CARE IS AGREED UPON BETWEEN PROVIDER AND PATIENT, AND TO HELP THE PATIENT IDENTIFY AND CHANGE ASPECTS OF THEIR LIFE WHICH MAY INTERFERE WITH MAINTAINING THEIR HEALTH AND QUALITY OF LIFE. PSYCHOTHERAPY SERVICES: HMS BEHAVIORAL HEALTH PROFESSIONALS PROVIDE SHORT-TERM AND MEDIUM-TERM INDIVIDUAL AND GROUP COUNSELING AND PSYCHOTHERAPY SERVICES TO HMS PATIENTS. SUCH SERVICES ARE PRINCIPALLY DESIGNED FOR MODERATE TO MEDIUM LEVEL DIFFICULTIES IN LIVING ENCOUNTERED BY PATIENTS. THOSE DEALING WITH SEVERE OR CHRONIC BEHAVIORAL HEALTH CHALLENGES WOULD MOST LIKELY BE REFERRED TO OTHER AGENCIES IN THE REGION FOR A MORE APPROPRIATE LEVEL OF CARE. HMS EMPLOYS STRENGTH-BASED PSYCHOTHERAPEUTIC STRATEGIES THAT ARE VALIDATED EMPIRICALLY FOR THE POPULATIONS SERVED. HMS MAINTAINS AN UNYIELDING COMMITMENT TO THE HIGHEST ETHICAL AND PROFESSIONAL STANDARDS IN THE DELIVERY OF THESE SERVICES. PREVENTIVE CARE: HMS BEHAVIORAL HEALTH PROFESSIONALS RECOGNIZE THAT BEHAVIORAL HEALTH PROBLEMS ARE FREQUENTLY SYMPTOMS OF LESS THAN HEALTHY STANDARDS OF LIVING WITHIN A GIVEN COMMUNITY. THUS HMS IS COMMITTED TO WORKING WITH OTHERS DEDICATED TO IMPROVING THE CONDITIONS OF LIFE IN OUR COMMUNITIES BY PARTICIPATING IN HEALTH FAIRS, CONDUCTING WORKSHOPS AND SPEAKING TO COMMUNITY GROUPS ON ISSUES RELATED TO THE MENTAL AND EMOTIONAL WELL BEING OF THE COMMUNITY. FURTHER, HMS IS ALSO COMMITTED TO CONTRIBUTING TO COMMUNITY RESPONSE PLANS TO EVENTS AND CONDITIONS WHICH ARE RECOGNIZED AS RISK FACTORS FOR EMOTIONAL AND MENTAL WELL-BEING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4C</FormAndLineReferenceDesc>
        <ExplanationTxt>DENTAL SERVICES: IN ADDITION TO PREVENTIVE DENTAL SERVICES, HMS DENTISTS PROVIDE DIAGNOSTIC AND RESTORATIVE DENTAL CARE AND CAN MEET MOST ORAL SURGERY NEEDS OF PATIENTS, INCLUDE FILLINGS, EXTRACTIONS, AND PARTIAL OR FULL PROSTHETICS. PANOREX (PANORAMA) X-RAY SERVICES ARE AVAILABLE AT BOTH LOCATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>BUSINESS RELATIONSHIP: BOARD MEMBERS FRANK CHAIRES AND RANDI YBARRA HAVE A BUSINESS RELATIONSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY MANAGEMENT. THE FORM 990 IS REVIEWED BY THE CFO AND THEN PROVIDED TO THE BOARD OF DIRECTORS AT A BOARD MEETING BEFORE FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: POLICIES AND PROCEDURES WILL BE PREPARED IN HMS'S FUNCTIONAL DEPARTMENTS, INCLUDING PERSONNEL, COMPLIANCE, FINANCIAL, QUALITY IMPROVEMENT, CLINICAL, AND OPERATIONAL. PARTICULAR ATTENTION WILL BE GIVEN TO AREAS OF POTENTIAL RISK IDENTIFIED IN THE RESULTS OF AN AUDIT OR RELEVANT RISK AREAS IDENTIFIED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL AND OTHER FEDERAL AND STATE GOVERNMENT AGENCIES. HMS'S SENIOR TEAM REVIEWS ALL OF THE POLICIES AND COLLABORATES WITH THE CHIEF COMPLIANCE OFFICER TO ENSURE ALL REGULATIONS AND COMPLIANCE. AFTER THE REVIEW, THE POLICIES ARE SENT TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION REVIEW: SEVERAL DIVISIONS HAVE HAD MARKET EVALUATIONS AND REVIEW ALTHOUGH IT HAS BEEN A DIVISION AT A TIME. THE MOST RECENT REVIEW WAS DONE IN JUNE 2025 FOR THE NURSING DIVISION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENT DISCLOSURE: 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 XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE WAS NO CHANGE IN THE OVERSIGHT PROCESS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>