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          <BusinessName>
            <BusinessNameLine1Txt>MCI USA</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6100 W PLANO PKWY SUITE 3500</AddressLine1Txt>
            <CityNm>PLANO</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75093</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONFERENCE SERVICES</ServicesDesc>
        <CompensationAmt>335000</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>QUADRANT INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1881 CAMPUS COMMONS DR SUITE 300</AddressLine1Txt>
            <CityNm>RESTON</CityNm>
            <StateAbbreviationCd>VA</StateAbbreviationCd>
            <ZIPCd>20191</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TEMPORARY STAFFING SERVICES</ServicesDesc>
        <CompensationAmt>259785</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SPECTRUM FINANCIAL SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>8614 WESTWOOD CENTER DR SUITE 700</AddressLine1Txt>
            <CityNm>VIENNA</CityNm>
            <StateAbbreviationCd>VA</StateAbbreviationCd>
            <ZIPCd>22182</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TEMPORARY STAFFING SERVICES</ServicesDesc>
        <CompensationAmt>149404</CompensationAmt>
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      <CntrctRcvdGreaterThan100KCnt>9</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>RE/CERTIFICATION</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>39663578</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39663578</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PRODUCTS &amp; SERVICES</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>3318103</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONFERENCE/SEMINARS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>2129900</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1761000</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>368900</ExclusionAmt>
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      <TotalProgramServiceRevenueAmt>45111581</TotalProgramServiceRevenueAmt>
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        <TotalRevenueColumnAmt>723603</TotalRevenueColumnAmt>
        <ExclusionAmt>723603</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>4899841</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>4974743</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-74902</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-74902</TotalRevenueColumnAmt>
        <ExclusionAmt>-74902</ExclusionAmt>
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      <GrossSalesOfInventoryAmt>306796</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>32301</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>274495</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>274495</RelatedOrExemptFuncIncomeAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>25682</TotalRevenueColumnAmt>
        <ExclusionAmt>25682</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>25682</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>46060459</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>45017176</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1043283</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>127263</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>50649</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>9951301</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1630039</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>999440</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>729989</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>12965027</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>131686</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>6777510</TotalAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>1030344</TotalAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1977565</TotalAmt>
      </OfficeExpensesGrp>
      <RoyaltiesGrp>
        <TotalAmt>42</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>2272799</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>194990</TotalAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>9800</TotalAmt>
      </ConferencesMeetingsGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>3566497</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>2103365</TotalAmt>
      </DepreciationDepletionGrp>
      <OtherExpensesGrp>
        <Desc>DUES &amp; SUBSCRIPTIONS</Desc>
        <TotalAmt>99713</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SPONSORSHIPS</Desc>
        <TotalAmt>75000</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>HONORARIUM</Desc>
        <TotalAmt>46269</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MAILING LIST</Desc>
        <TotalAmt>45260</TotalAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>26277</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>44810825</TotalAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>1242852</EOYAmt>
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        <EOYAmt>2090665</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>2988</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>497519</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>14084524</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
        <BOYAmt>4942689</BOYAmt>
        <EOYAmt>3345977</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>39541687</EOYAmt>
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      <OtherAssetsTotalGrp>
        <BOYAmt>5768305</BOYAmt>
        <EOYAmt>23508024</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>44009302</BOYAmt>
        <EOYAmt>70229712</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>861757</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>8288222</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>6798900</BOYAmt>
        <EOYAmt>27717718</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>9377183</BOYAmt>
        <EOYAmt>36867697</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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        <BOYAmt>34632119</BOYAmt>
        <EOYAmt>33362015</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>34632119</BOYAmt>
        <EOYAmt>33362015</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>44009302</BOYAmt>
        <EOYAmt>70229712</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>1249634</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>3344134</NetUnrlzdGainsLossesInvstAmt>
      <PriorPeriodAdjustmentsAmt>-5863872</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>952722</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>822504</DepreciationAmt>
        <BookValueAmt>130218</BookValueAmt>
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      <EquipmentGrp>
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        <BookValueAmt>164447</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
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      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AMERICAN NURSES FOUNDATION, INC.</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AMERICAN NURSES ASSOCIATION, INC.</Desc>
        <Amt>27702449</Amt>
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      <FootnoteTextInd>X</FootnoteTextInd>
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      <NetUnrealizedGainsInvstAmt>3344134</NetUnrealizedGainsInvstAmt>
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      <RevenueNotReportedAmt>3376435</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>45928773</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>131686</InvestmentExpensesNotIncldAmt>
      <RevenueNotReportedFinclStmtAmt>131686</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>46060459</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>44711440</TotExpnsEtcAuditedFinclStmtAmt>
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      <ExpensesNotReportedAmt>32301</ExpensesNotReportedAmt>
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      <ExpensesNotRptFinclStmtAmt>131686</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>44810825</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PERFORMED AN EVALUATION OF UNCERTAINTY IN INCOME TAXES FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019, AND DETERMINED THAT THERE WERE NO MATTERS THAT WOULD REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OR THAT MAY HAVE ANY EFFECT ON ITS TAX-EXEMPT STATUS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>COST OF GOODS SOLD 32,301.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>COST OF GOODS SOLD 32,301.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>AMERICAN NURSES FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>8515 GEORGIA AVENUE SUITE 400</AddressLine1Txt>
          <CityNm>SILVER SPRING</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20910</ZIPCd>
        </USAddress>
        <RecipientEIN>131893924</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>65528</CashGrantAmt>
        <PurposeOfGrantTxt>CLINICAL RESEARCH GRANT SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CVS MINUTE CLINIC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>ONE CVS DRIVE</AddressLine1Txt>
          <CityNm>WOONSOCKET</CityNm>
          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02895</ZIPCd>
        </USAddress>
        <RecipientEIN>411939629</RecipientEIN>
        <IRCSectionDesc>N/A</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <PurposeOfGrantTxt>PATHWAY AWARD SPONSORSHIP</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SIGMA THETA TAU</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>550 WEST NORTH ST</AddressLine1Txt>
          <CityNm>INDIANAPOLIS</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>46202</ZIPCd>
        </USAddress>
        <RecipientEIN>416022987</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <PurposeOfGrantTxt>RESEARCH GRANT FUNDING</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>2</Total501c3OrgCnt>
      <TotalOtherOrgCnt>1</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>RECIPIENTS HAVE 12 MONTHS TO USE THE GRANT FOR RESEARCH DESCRIBED IN THE APPLICATION. IF THE RESEARCH IS COMPLETED WITHIN 12 MONTHS, THE RECIPIENT HAS 60 DAYS TO CLOSE OUT. IF THE RECIPIENT HAS NOT COMPLETED THE RESEARCH, THEY ARE ALLOWED TO FILE FOR AN EXTENSION OF 12 MONTHS. THE RECIPIENT IS REQUIRED TO NOTIFY ANCC IF THERE ARE ANY ALTERATIONS TO THE BUDGET THAT WAS SUBMITTED AS PART OF THE APPLICATION PROCESS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
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      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DEBRA HATMAKER</PersonNm>
        <TitleTxt>CHIEF NURSING OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>327570</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>2249</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>2096</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>348963</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GREGORY DYSON</PersonNm>
        <TitleTxt>CHIEF OPERATING OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>245036</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>2249</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>19263</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>12490</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>279038</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LYNN WASYLINA</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>241418</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>2249</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>3802</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATHY CHAPPELL</PersonNm>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LORESSA COLE</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER</TitleTxt>
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        <BonusRelatedOrganizationsAmt>2141</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>11047</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>6125</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>212896</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <PersonNm>ERNEST J GRANT PHD RN FAAN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>203348</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <TotalCompensationRltdOrgsAmt>203348</TotalCompensationRltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION TO ESTABLISH COMPENSATION OF THE CEO AND OTHER OFFICERS. THE RELATED ORGANIZATION USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS; THEY INCLUDE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. JOBS AND SALARY GRADES ARE BENCHMARKED TO ENSURE THAT THE ORGANIZATION REMAINS COMPETITIVE IN THE CURRENT LABOR MARKET. ALL UNION POSITIONS ARE COVERED BY THE UNION CONTRACT. THESE PROCESSES ARE DOCUMENTED AND HELD IN THE HUMAN RESOURCES DEPARTMENT BY THE DIRECTOR OF HUMAN RESOURCES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>EXECUTIVE COMMITTEE: A. THE COMMITTEE SHALL HAVE THE AUTHORITY TO EXERCISE ALL THE POWERS OF THE FULL BODY BETWEEN MEETINGS. ACTION TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE REPORTED AND BE SUBJECT TO RATIFICATION AT THE NEXT MEETING OF THE FULL BODY. B. THE COMMITTEE SHALL CONSIST OF A CHAIRPERSON, VICE CHAIRPERSON, AND ONE MEMBER-AT-LARGE WHO ARE ELECTED BY AND AMONG SITTING MEMBERS OF THE BODY THAT THEY WILL REPRESENT. C. COMMITTEE MEMBERS SHALL SERVE TERMS OF TWO YEARS OR UNTIL THEIR SUCCESSORS ARE ELECTED. NO MEMBERS SHALL SERVE MORE THAN TWO CONSECUTIVE TERMS IN THE SAME OFFICE. D. MEMBERS MAY ELECT AN INDIVIDUAL WITH LESS THAN TWO YEARS REMAINING TO HIS OR HER APPOINTMENT; HOWEVER, VACANCIES MAY BE FILLED ONLY FOR THE REMAINDER OF THE UNEXPIRED TERM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>AMERICAN NURSES CREDENTIALING CENTER (ANCC) HAS A STRATEGIC PARTNERSHIP AGREEMENT WITH THE AMERICAN NURSES ASSOCIATION (ANA), WHEREBY ANA PROVIDES MANAGEMENT AND ADMINISTRATIVE SUPPORT SERVICES FOR ANCC. ANA SERVICES CONSIST OF THOSE TYPICALLY PROVIDED BY A CFO, INCLUDING IN PERTINENT PART: PREPARATION OF MONTHLY FINANCIAL STATEMENTS, OVERSIGHT OF THE ANNUAL AUDIT, TAX RETURN PREPARATION, INVESTMENT ASSISTANCE, AND ADVICE AND COUNSEL ON FINANCES. IN ADDITION, ANCC HAS AGREED TO ADHERE TO ANA ADMINISTRATIVE AND FINANCIAL PROCESSES AND POLICIES (E.G., PURCHASING, DOCUMENT RETENTION AND CONTRACT APPROVAL). UNDER THIS AGREEMENT, ANCC BUDGET IS PREPARED IN CONSULTATION WITH ANA.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS CONSISTS OF THE FOLLOWING: (A) THE PRESIDENT OF AMERICAN NURSES ASSOCIATION, INC.; (B) THE CHIEF EXECUTIVE OFFICER OF AMERICAN NURSES ASSOCIATION, INC.; AND UP TO SEVEN ADDITIONAL DIRECTORS AS APPOINTED BY THE AMERICAN NURSES ASSOCIATION, INC.'S BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>AMENDMENTS TO ANCC'S GOVERNING DOCUMENTS MUST BE APPROVED BY A TWO-THIRDS VOTE OF THE AMERICAN NURSES ASSOCIATION, INC.'S BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE DRAFT VERSION OF THE FEDERAL FORM 990 IS REVIEWED IN DETAIL BY THE CHIEF OPERATING OFFICER AND CONTROLLER TO ENSURE THAT THE DETAILS TIE TO THE AUDITED FINANCIAL STATEMETNS AND APPROPRIATELY REPRESENT ALL FINANCIAL ACTIVITIES OF ANA. A COPY OF THE DRAFT FEDERAL FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS, THE CHIEF EXECUTIVE OFFICER AND THE CHIEF NURSING OFFICER PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMERICAN NURSES CREDENTIALING CENTER (ANCC) BOARD MEMBERS SIGN DISCLOSURE STATEMENTS UPON ELECTION OR APPOINTMENT, EVERY TWO YEARS THE BOARD OF DIRECTORS FORMALLY ADOPTED THE USE OF CONFLICT OF INTEREST STATEMENTS AND DISCLOSURE FORMS THE DISCLOSURE FORMS SIGNED BY ANCC BOARD MEMBERS ARE REVIEWED BY THE CHIEF NURSING OFFICER ANY CONFLICT OR POTENTIAL CONFLICT OF INTEREST WOULD BE BROUGHT TO THE ATTENTION OF THE ANCC PRESIDENT OR GENERAL COUNSEL. PERIODIC TRAINING FOR BOARD OF DIRECTORS INCLUDES REFERENCE TO THE MEMBERS' FIDUCIARY OBLIGATIONS, INCLUDING THE AVOIDANCE OF A CONFLICT OF INTEREST THE BOARD OF DIRECTORS HAS AN OPERATING POLICY THAT PROHIBITS CONFLICT OF INTEREST, AND THE ANCC PRESIDENT CALLS FOR DISCLOSURE OF CONFLICTS AT THE BEGINNING OF EVERY MEETING CONFLICTED INDIVIDUALS WILL NOT VOTE ON THE MATTER ABOUT WHICH THEY ARE CONFLICTED, AND MAY OR MAY NOT PARTICIPATE IN THE DISCUSSION OF THE MATTER, DEPENDING UPON THE ISSUE AND WHETHER DISCLOSURE OF THE CONFLICT TO THE BOARD PROVIDES ENOUGH PROTECTION TO PERMIT THE BOARD MEMBER TO COMMENT ON THE MATTER OR TO HEAR THE DISCUSSION THE MINUTES REFLECT REFERENCES TO AND DECISIONS ABOUT CONFLICT OF INTEREST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>ANCC PRESIDENT RECEIVED HONORARIUM FOR HER SERVICES THAT IS REVIEWED ANNUALLY BY THE ANA EXECUTIVE COMMITTEE AND REFERRED TO ANCC BOARD FOR APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ANCC DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR THE FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, SECTION A:</FormAndLineReferenceDesc>
        <ExplanationTxt>ANCC DOES NOT DIRECTLY HIRE OR COMPENSATE EMPLOYEES. ALL EMPLOYEES ARE EMPLOYEES OF AMERICAN NURSES ASSOCIATION (ANA), A RELATED ORGANIZATION EXEMPT UNDER SECTION 501(C)(6). ANA AND ANCC HAVE ENTERED INTO A COST SHARING ARRANGEMENT UNDER WHICH ANCC REIMBURSES ANA FOR ANCC'S ALLOCABLE SHARE OF THE COMPENSATION OF CERTAIN EMPLOYEES FOR PERFORMING SERVICES PROVIDED TO ANCC. COMPENSATION REIMBURSED BY ANCC IS NOT ADDITIVE TO THE COMPENSATION REPORTED BY ANA.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONSULTING SERVICES 6,362,190. TEMPORARY HELP 415,320.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <BusinessNameLine1Txt>AMERICAN NURSES ASSOCIATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>8515 GEORGIA AVENUE SUITE 400</AddressLine1Txt>
          <CityNm>SILVER SPRING</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20910</ZIPCd>
        </USAddress>
        <EIN>131893923</EIN>
        <PrimaryActivitiesTxt>PROFESSIONAL/LABOR ORGANIZATION FOR REGISTERED NURSES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(6)</ExemptCodeSectionTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <AddressLine1Txt>8515 GEORGIA AVENUE SUITE 400</AddressLine1Txt>
          <CityNm>SILVER SPRING</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20910</ZIPCd>
        </USAddress>
        <EIN>131893924</EIN>
        <PrimaryActivitiesTxt>SCIENTIFIC RESEARCH, EDUCATION SUPPORT, CHARITABLE AFFILIATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>AMERICAN ACADEMY OF NURSING</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1000 VERMONT AVENUE NW SUITE 910</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
        </USAddress>
        <EIN>522213870</EIN>
        <PrimaryActivitiesTxt>PROVIDE VISIONARY LEADERSHIP TO THE NURSING PROFESSION AND THE PUBLIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>INSTITUTE FOR NURSING RESEARCH AND EDUCATION</BusinessNameLine1Txt>
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        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>ANA SERVICE CORPORATION INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>8515 GEORGIA AVENUE SUITE 400</AddressLine1Txt>
          <CityNm>SILVER SPRING</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
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        <EIN>542179203</EIN>
        <PrimaryActivitiesTxt>INACTIVE SUBSIDIARY</PrimaryActivitiesTxt>
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      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
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        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>12961727</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK VALUE</MethodOfAmountDeterminationTxt>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>AMERICAN NURSES ASSOCIATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>3566497</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK VALUE</MethodOfAmountDeterminationTxt>
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      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AMERICAN NURSES ASSOCIATION INC</BusinessNameLine1Txt>
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        <TransactionTypeTxt>N</TransactionTypeTxt>
        <InvolvedAmt>2272799</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
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          <BusinessNameLine1Txt>AMERICAN NURSES FOUNDATION INC</BusinessNameLine1Txt>
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        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>65528</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
