<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-05-15T00:13:23-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>480567703</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>PINION LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>828 GREAT NORTHERN BOULEVARD</AddressLine1Txt>
        <CityNm>HELENA</CityNm>
        <StateAbbreviationCd>MT</StateAbbreviationCd>
        <ZIPCd>59601</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>237338233</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MONTANA HEALTH RESEARCH &amp;</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>EDUCATION FOUNDATION</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>MONT</BusinessNameControlTxt>
      <PhoneNum>4064421911</PhoneNum>
      <USAddress>
        <AddressLine1Txt>2625 WINNE AVE</AddressLine1Txt>
        <CityNm>HELENA</CityNm>
        <StateAbbreviationCd>MT</StateAbbreviationCd>
        <ZIPCd>59601</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>AMBER DUSHIN</PersonNm>
      <PersonTitleTxt>CHIEF FINANCIAL OFFICER</PersonTitleTxt>
      <PhoneNum>4064421911</PhoneNum>
      <SignatureDt>2024-05-14</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>AMBER</PersonFirstNm>
        <PersonLastNm>DUSHIN</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>LAURA CRAFT</PreparerPersonNm>
      <PTIN>P01713487</PTIN>
      <PhoneNum>4064421040</PhoneNum>
      <PreparationDt>2024-05-13</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2023</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>AMBER DUSHIN</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>2625 WINNE AVE</AddressLine1Txt>
        <CityNm>HELENA</CityNm>
        <StateAbbreviationCd>MT</StateAbbreviationCd>
        <ZIPCd>59601</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>3093649</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>HTTP://WWW.MTHA.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1973</FormationYr>
      <LegalDomicileStateCd>MT</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PURSUE FUNDING OPPORTUNITIES TO PROVIDE FINANCIAL, TECHNICAL, AND INNOVATIVE PROGRAM SUPPORT TO MHA MEMBERS AND THE COMMUNITIES THEY SERVE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>8</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>7</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>8</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>3671836</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>3031691</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>109297</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>51380</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>9504</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>7544</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>3790637</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>3090615</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>854253</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>501807</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>1470888</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1409937</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>1375406</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>1169534</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>3700547</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>3081278</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>90090</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>9337</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>2071944</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>2006835</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>785169</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>685514</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>1286775</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>1321321</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TO PURSUE FUNDING OPPORTUNITIES TO PROVIDE FINANCIAL, TECHNICAL, AND INNOVATIVE PROGRAM SUPPORT TO MHA MEMBERS AND THE COMMUNITIES THEY SERVE.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>297903</ExpenseAmt>
      <Desc>THE CDC HEALTH EQUITY GRANT: TO IMPLEMENT HEALTH EQUITY ACTIVITIES, INCLUDING SUPPORTING HEALTHCARE FACILITIES TO DEVELOP COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS, FACILITATING REGIONAL HEALTH EQUITY TASK FORCES, AND PROVIDING HEALTH EQUITY EDUCATION. ADDITIONALLY, THE GRANT FINANCIALLY SUPPORTS SUBCONTRACTS FOR THE DEVELOPMENT OF A MONTANA SPECIFIC SOCIAL DETERMINANTS OF HEALTH TOOL (MONTANA INDEX OF HEALTHY COMMUNITIES) AND REGIONAL CARE COORDINATION TO PROMOTE THE COMMUNITY HEALTH WORKER AND COMMUNITY INTEGRATED HEALTH PROFESSIONAL WORKFORCE.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>675608</ExpenseAmt>
        <Desc>RURAL HOSPITAL FELEXIBILITY GRANT (FLEX):HRSA FUNDED GRANT TO PROVIDE SUPPORT FOR CRITICAL ACCESS AND OTHERSMALL RURAL HOSPITALS TO PRESERVE ACCESS TO PRIMARY AND EMERGENCYHEALTH CARE SERVICES IN THEIR COMMUNITIES. SPECIFICALLY, THE GRANT ISINTENDED TO STRENGTHEN CRITICAL ACCESS HOSPITAL INFRASTRUCTURE, SUPPORT LEADERSHIP, ENHANCE RURAL EMERGENCY MEDICAL SERVICE, IMPROVE QUALITY, AND DEVELOP AND ENHANCE NETWORKS OF CARE.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>1308185</ExpenseAmt>
        <GrantAmt>309256</GrantAmt>
        <Desc>HOSPITAL PREPAREDNESS PROGRAM:ASPR FUNDED GRANT TO ASSIST HOSPITALS IN ASSESSING THEIR PREPAREDNESS IN THE EVENT OF EMERGENCIES OR NATURAL DISASTERS, AND FORMULATING AND TESTING PLANS TO STRENGTHEN THEIR READINESS.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>176995</ExpenseAmt>
        <GrantAmt>192551</GrantAmt>
        <RevenueAmt>51380</RevenueAmt>
        <Desc>TELESTROKE SERVICES GRANT:CDC FUNDED PROGRAM THROUGH THE MONTANA DPHHS TO IMPROVE PATIENT CARE IN RURAL HOSPITALS THROUGH TELEVIDEO AHEC GRANTS (SC AND NC PROGRAMS):HRSA FUNDED GRANTS THORUGH THE STATE OFFICE OF RURAL HEALTH TO STRENGTHEN THE HEALTHCARE WORKFORCE IN MONTANA, PARTICULARLY IN RURAL AND UNDERSERVED COMMUNITES, AND TO IMPROVE HEALTH BY FORGING CONNECTIONS BETWEEN HEALTH PROFESSIONS, K-12 EDUCATIONAL PROGRAMS, AND COMMUNITITES.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>176995</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>192551</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>51380</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>2458691</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>1</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">0</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">1</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">1</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>0</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <InfoInScheduleOPartVInd>X</InfoInScheduleOPartVInd>
      <IRPDocumentCnt>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>8</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>7</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>MONTANA HEALTH RESEARCH &amp; EDUCATION FOUNDATION</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>4064421911</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2625 WINNE AVENUE</AddressLine1Txt>
          <CityNm>HELENA</CityNm>
          <StateAbbreviationCd>MT</StateAbbreviationCd>
          <ZIPCd>59601</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT OLSEN</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>30998</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>543</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLEY EVANS</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CODY LANGBEHN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEVIN HUNTLEY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURA MERCHANT</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ADAM SCHAFER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KRISTI GATRELL</PersonNm>
        <TitleTxt>VICE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATT WALLER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHANI RICH</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>106625</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26068</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>106625</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>30998</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>26611</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CYNOSURE HEALTH</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1688 ORVIETTO DR</AddressLine1Txt>
            <CityNm>ROSEVILLE</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95661</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTH CARE CONSULTING</ServicesDesc>
        <CompensationAmt>101712</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>2901691</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>130000</AllOtherContributionsAmt>
      <TotalContributionsAmt>3031691</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>CONVENTIONS &amp; WORKSHOP</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>51380</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>51380</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>51380</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>6163</TotalRevenueColumnAmt>
        <ExclusionAmt>6163</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>4415</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>3034</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1381</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1381</TotalRevenueColumnAmt>
        <ExclusionAmt>1381</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>3090615</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>51380</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>7544</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>309256</TotalAmt>
        <ProgramServicesAmt>309256</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>192551</TotalAmt>
        <ProgramServicesAmt>192551</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>220970</TotalAmt>
        <ManagementAndGeneralAmt>220970</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>789455</TotalAmt>
        <ProgramServicesAmt>744507</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44948</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>95563</TotalAmt>
        <ProgramServicesAmt>76470</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19093</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>197327</TotalAmt>
        <ProgramServicesAmt>168249</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29078</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>106622</TotalAmt>
        <ProgramServicesAmt>87305</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19317</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>28165</TotalAmt>
        <ManagementAndGeneralAmt>28165</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>572</TotalAmt>
        <ProgramServicesAmt>572</ProgramServicesAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>461354</TotalAmt>
        <ProgramServicesAmt>431551</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29803</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>638</TotalAmt>
        <ProgramServicesAmt>638</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>157082</TotalAmt>
        <ProgramServicesAmt>92046</ProgramServicesAmt>
        <ManagementAndGeneralAmt>65036</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>132</TotalAmt>
        <ProgramServicesAmt>132</ProgramServicesAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>124411</TotalAmt>
        <ManagementAndGeneralAmt>124411</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>129050</TotalAmt>
        <ProgramServicesAmt>121328</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7722</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>212843</TotalAmt>
        <ProgramServicesAmt>206496</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6347</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>673</TotalAmt>
        <ManagementAndGeneralAmt>673</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>16340</TotalAmt>
        <ProgramServicesAmt>991</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15349</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>OTHER EXPENSES</Desc>
        <TotalAmt>24987</TotalAmt>
        <ProgramServicesAmt>13312</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11675</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>7194</TotalAmt>
        <ProgramServicesAmt>7194</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER PROGRAM EXPENSES</Desc>
        <TotalAmt>6000</TotalAmt>
        <ProgramServicesAmt>6000</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FOREIGN TAXES</Desc>
        <TotalAmt>93</TotalAmt>
        <ProgramServicesAmt>93</ProgramServicesAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>3081278</TotalAmt>
        <ProgramServicesAmt>2458691</ProgramServicesAmt>
        <ManagementAndGeneralAmt>622587</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>100</BOYAmt>
        <EOYAmt>14316</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>363493</BOYAmt>
        <EOYAmt>410194</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>8444</BOYAmt>
        <EOYAmt>4844</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>209467</BOYAmt>
        <EOYAmt>236222</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1490440</BOYAmt>
        <EOYAmt>1341259</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>2071944</BOYAmt>
        <EOYAmt>2006835</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>143843</BOYAmt>
        <EOYAmt>101928</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>641326</BOYAmt>
        <EOYAmt>583586</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>785169</BOYAmt>
        <EOYAmt>685514</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>1185470</BOYAmt>
        <EOYAmt>1220016</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>101305</BOYAmt>
        <EOYAmt>101305</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>1286775</BOYAmt>
        <EOYAmt>1321321</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>2071944</BOYAmt>
        <EOYAmt>2006835</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>9337</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>25877</NetUnrlzdGainsLossesInvstAmt>
      <InvestmentExpenseAmt>-668</InvestmentExpenseAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>3130227</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2741331</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4214057</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3671836</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3031691</CurrentTaxYearAmt>
        <TotalAmt>16789142</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>3130227</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2741331</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4214057</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3671836</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3031691</CurrentTaxYearAmt>
        <TotalAmt>16789142</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>16789142</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>4218</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4119</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4212</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4802</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>6163</CurrentTaxYearAmt>
        <TotalAmt>23514</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>16812656</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>2239457</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.99860</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99840</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>209467</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>33327</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>6000</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>572</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>236222</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>257752</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>-41723</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>6000</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>562</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>209467</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>216312</BeginningYearBalanceAmt>
        <ContributionsAmt>10000</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>33015</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>1000</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>575</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>257752</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>199035</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>25256</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>7500</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>479</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>216312</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>168437</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>33358</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>2300</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>460</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>199035</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.57000</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.43000</PrmnntEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
      <TotalBookValueLandBuildingsAmt>0</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>INVESTMENTS</Desc>
        <BookValueAmt>236222</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>236222</TotalBookValueSecuritiesAmt>
      <OtherAssetsOrgGrp>
        <Desc>INTER-COMPANY DUE TO/DUE FROM</Desc>
        <BookValueAmt>1341259</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>1341259</TotalBookValueOtherAssetsAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART V, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>TO SUPPORT RESEARCH AND CHARITABLE ACTIVITIES WHICH BENEFIT THE MEDICAL COMMUNITY IN MONTANA AND TO IMPROVE THE HEALTH OF ITS RESIDENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>0</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>STILLWATER BILLINGS CLINIC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>710 11TH ST N</AddressLine1Txt>
          <CityNm>COLUMBUS</CityNm>
          <StateAbbreviationCd>MT</StateAbbreviationCd>
          <ZIPCd>59019</ZIPCd>
        </USAddress>
        <RecipientEIN>810286525</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>18000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>TRAINING</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>TRAVEL AND TRAINING REIMBURSEMENT</GrantTypeTxt>
        <RecipientCnt>206</RecipientCnt>
        <CashGrantAmt>192551</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART V, LINE 2B</FormAndLineReferenceDesc>
        <ExplanationTxt>MHREF'S EMPLOYMENT TAX INFORMATION IS COMBINED WITH AND REPORTED BY MONTANA HOSPITAL ASSOCIATION, SERVING AS THE COMMON PAYMASTER, UNDER ITS EIN #81-0287203.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL MEMBERS OF THE BOARD RECEIVE A COPY OF THE FORM 990 PRIOR TO FILING. IT IS REVIEWED IN DETAIL BY THE FINANCE COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CONFLICT OF INTEREST POLICY REQUIRES BOARD MEMBERS TO ANNUALLY SUBMIT A REPORT TO THE BOARD OF ALL ORGANIZATIONS OR BUSINESSES OF WHICH THE INDIVIDUAL IS A MEMBER, OFFICER, EMPLOYEE OR OWNER WHICH HAVE CONFLICTING INTERESTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN OR PERSONAL REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 29,803. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,803. CONSULTING/CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 431,551. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 431,551.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE HAVE BEEN NO CHANGES FROM PRIOR YEAR IN THE AUDIT OVERSIGHT AND SELECTION PROCESS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
