﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2018v3.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2020-08-17T16:17:42-05:00</ReturnTs>
    <TaxPeriodEndDt>2019-09-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>920127098</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>ELGEE REHFELD LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>9309 GLACIER HWY STE B200</AddressLine1Txt>
        <CityNm>JUNEAU</CityNm>
        <StateAbbreviationCd>AK</StateAbbreviationCd>
        <ZIPCd>998019300</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2018-10-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>920056274</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>SOUTHEAST ALASKA REGIONAL HEALTH</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>CONSORTIUM</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>SOUT</BusinessNameControlTxt>
      <PhoneNum>9074634000</PhoneNum>
      <USAddress>
        <AddressLine1Txt>3100 CHANNEL DRIVE SUITE 300</AddressLine1Txt>
        <CityNm>JUNEAU</CityNm>
        <StateAbbreviationCd>AK</StateAbbreviationCd>
        <ZIPCd>99801</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>LELAND SCHLATTER</PersonNm>
      <PersonTitleTxt>DIRECTOR OF FINANCE</PersonTitleTxt>
      <PhoneNum>9073644597</PhoneNum>
      <SignatureDt>2020-08-15</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>ROBERT L REHFELD</PreparerPersonNm>
      <PTIN>P00104959</PTIN>
      <PhoneNum>9077893178</PhoneNum>
      <PreparationDt>2020-08-17</PreparationDt>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>24.237.4.179</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2020-08-17</IPDt>
      <IPTm>16:17:42</IPTm>
      <IPTimezoneCd>CD</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>E322EE2B4FC9630B23A8874FD127DC1B5CEE0083</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>AE4CABE6EA5C8B5397C368CD64899C3BD3DCD21D</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2018</TaxYr>
    <BuildTS>2020-09-22 18:59:49Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="11">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc9">
      <AddressChangeInd>X</AddressChangeInd>
      <PrincipalOfficerNm>CHARLES CLEMENT</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>3245 HOSPITAL DRIVE</AddressLine1Txt>
        <CityNm>JUNEAU</CityNm>
        <StateAbbreviationCd>AK</StateAbbreviationCd>
        <ZIPCd>99801</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>209748045</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>HTTP://WWW.SEARHC.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1975</FormationYr>
      <LegalDomicileStateCd>AK</LegalDomicileStateCd>
      <ActivityOrMissionDesc>ALASKA NATIVE PEOPLE WORKING IN PARTNERSHIP TO PROVIDE THE BEST HEALTHCARE FOR OUR COMMUNITIES.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>15</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>15</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>1162</TotalEmployeeCnt>
      <TotalVolunteersCnt>3</TotalVolunteersCnt>
      <TotalGrossUBIAmt>-566</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>80360294</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>90940617</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>101854614</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>113310729</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1778809</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>3055256</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>807468</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>2441443</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>184801185</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>209748045</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>886552</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>174423</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>92235429</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>113683770</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>72298407</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>73195445</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>165420388</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>187053638</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>19380797</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>22694407</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>203983791</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>240707877</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>30942383</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>42613841</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>173041408</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>198094036</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>ALASKA NATIVE PEOPLE WORKING IN PARTNERSHIP TO PROVIDE THE BEST HEALTHCARE FOR OUR COMMUNITIES.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>42601745</ExpenseAmt>
      <RevenueAmt>24667764</RevenueAmt>
      <Desc>OUTPATIENT SERVICES - THIS PROGRAM PROVIDES PRIMARY HEALTH CARE SERVICES TO MOST COMMUNITIES OF SOUTHEAST ALASKA. THESE INCLUDE PHYSICIAN, MID-LEVEL, AND COMMUNITY HEALTH AIDE PROVIDERS AND TRAINING, ENVIRONMENTAL HEALTH, HEALTH PROMOTION AND PREVENTIVE SERVICES, FAMILY SERVICES, REMOTE MAINTENANCE SERVICES, AND EMERGENCY MEDICAL SERVICES. CLINIC LOCATIONS INCLUDE: ANGOON, HAINES, HYDABURG, JUNEAU, WRANGELL, KAKE, KASAAN, KLAWOCK, KLUKWAN, PELICAN, SITKA, HOONAH AND THORNE BAY. ADDITIONAL PRIMARY CARE AND/OR SPECIALIST SERVICES ARE PROVIDED IN PETERSBURG, SKAGWAY, AND YAKUTAT. IN FISCAL YEAR 2019, SEARHCS OUTPATIENT CLINICS PROVIDED SERVICES TO SOUTHEAST ALASKA RESIDENTS IN 158,757 OUTPATIENT VISITS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>33804555</ExpenseAmt>
        <RevenueAmt>28748019</RevenueAmt>
        <Desc>INPATIENT SERVICES - THIS PROGRAM PROVIDES INPATIENT SERVICES AT MT. EDGECUMBE HOSPITAL (MEH) IN SITKA. PATIENTS ARE REFERRED TO MEH FROM ALL OVER SOUTHEAST ALASKA. SHORT TERM HOUSING IS AVAILABLE ON THE CAMPUS FOR THE COMFORT AND HEALING OF ESCORTS AND FAMILY MEMBERS. MEH IS A LEVEL IV TRAUMA CENTER. IN FISCAL YEAR 2019, SEARHCS INPATIENT HOSPITAL ADMISSIONS WERE 719.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>26188059</ExpenseAmt>
        <RevenueAmt>39411563</RevenueAmt>
        <Desc>ANCILLARY SERVICES PROVIDED, SUCH AS LAB, RADIOLOGY, AND PHARMACY WHICH INCLUDE REMOTE AND TECHNOLOGY BASED SUPPORT; THESE SERVICES ARE PROVIDED IN MOST COMMUNITIES OF SOUTHEAST ALASKA. CLINIC LOCATIONS INCLUDE: ANGOON, HAINES, HYDABURG, JUNEAU, WRANGELL, KAKE, KASAAN, KLAWOCK, KLUKWAN, PELICAN, SITKA, HOONAH AND THORNE BAY. IN FISCAL YEAR 2019, SEARHCS ANCILLARY SERVICES TO SOUTHEAST ALASKA RESIDENTS WERE IN 643,259 PRESCRIPTIONS, LABS AND RADIOLOGY PROCEDURES.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>47995671</ExpenseAmt>
        <GrantAmt>174423</GrantAmt>
        <RevenueAmt>22763918</RevenueAmt>
        <Desc>OTHER PROGRAM SERVICES PROVIDED INCLUDE BEHAVIORAL HEALTH SERVICES INCLUDING RURAL SUBSTANCE ABUSE, RURAL MENTAL HEALTH, SOCIAL SERVICES, AND MENTAL HEALTH OUTPATIENT SERVICES; DENTAL SERVICES ARE PROVIDED TO MOST SOUTHEAST ALASKA COMMUNITIES. SERVICES INCLUDE ROUTINE ADULT AND CHILD DENTAL CARE, PATIENT EDUCATION, DENTAL DISEASE PREVENTION, EMERGENCY CARE AND ORTHODONTICS; REGIONAL PREVENTION SERVICES FOCUSING ON HEALTH LIFE STYLE CHANGES, EDUCATION AND PREVENTION; AND PURCHASED/REFERRED CARE PROGRAM WHICH PROVIDES ELIGIBLE BENEFICIARIES WITH ACCESS TO ACUTE, TERTIARY AND QUATERNARY CLINICAL CARE SERVICES.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>47995671</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>174423</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>22763918</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>150590030</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc11">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc3">false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc3">true</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc3">false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc4">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc4">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc4">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc4">false</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc4">true</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc4">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc4">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc4">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc4">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc4">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc4">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc4">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc4">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc5">true</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc5">false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc6">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="RetDoc7">true</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>false</InvestTaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd>false</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="RetDoc8">true</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="RetDoc8">false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc10">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc10">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc10">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc10">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>false</ScheduleORequiredInd>
      <IRPDocumentCnt>366</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>1162</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>true</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>15</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>15</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>THE ORGANIZATION</PersonNm>
        <PhoneNum>9073644597</PhoneNum>
        <USAddress>
          <AddressLine1Txt>3100 CHANNEL DR STE 300</AddressLine1Txt>
          <CityNm>JUNEAU</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99801</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY STRONG</PersonNm>
        <TitleTxt>BOARD CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>8.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>2940</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HARRIET BROUILLETTE</PersonNm>
        <TitleTxt>BOARD VICE C</TitleTxt>
        <AverageHoursPerWeekRt>8.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1350</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAVINA BROCK</PersonNm>
        <TitleTxt>BOARD SECRET</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1880</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HARRIET SILVA</PersonNm>
        <TitleTxt>BOARD TREASU</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1680</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINCOLN BEAN SR</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1080</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DELLA COBURN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>960</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATTY COTTLE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>2751</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VERONICA DALTON</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1080</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JUNE DURGAN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1380</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JUDEAN GORDON</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1835</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES JACK SR</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>3460</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN MORRIS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>2430</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROSS NANNAUCK</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1080</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARVELL NIX</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1560</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FREDERICK OLSEN JR</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>120</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAWRENCE WIDMARK</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1080</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHARLES CLEMENT</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1018373</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28779</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL NEUMEISTER</PersonNm>
        <TitleTxt>SENIOR EXECU</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>531435</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14934</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL HARRIS</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>415159</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>2462</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT C WOLF</PersonNm>
        <TitleTxt>VP, CHIEF OP</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>330564</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20714</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL DOUGLAS</PersonNm>
        <TitleTxt>VP, CHIEF LE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>321148</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18850</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LEATHA MERCULIEFF</PersonNm>
        <TitleTxt>VP, EXECUTIV</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>280943</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15305</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHELLE A KOONTZ</PersonNm>
        <TitleTxt>VP, CHIEF HU</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>269275</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20557</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELLIOT J BRUHL</PersonNm>
        <TitleTxt>VP, CHIEF ME</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID A BROWN</PersonNm>
        <TitleTxt>PHYSICIAN -</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>617717</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11277</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERRENCE E BABB</PersonNm>
        <TitleTxt>PHYSICIAN -</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>506425</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24755</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LOREN E LAYBOURN</PersonNm>
        <TitleTxt>PHYSICIAN -</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>487587</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28311</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL SPARKS</PersonNm>
        <TitleTxt>PHYSICAN-SUR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>409938</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20452</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUPRIYA GIANCHANDANI</PersonNm>
        <TitleTxt>PHYSICAN-ENT</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>358866</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>5574096</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>206396</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>195</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>XTEND HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>500 W MAIN STREET SUITE 14</AddressLine1Txt>
            <CityNm>HENDERSONVILLE</CityNm>
            <StateAbbreviationCd>TN</StateAbbreviationCd>
            <ZIPCd>37075</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>BILLING/CODING</ServicesDesc>
        <CompensationAmt>4131945</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ECG MANAGEMENT CONSULTANTS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1111 THIRD AVE SUITE 2500</AddressLine1Txt>
            <CityNm>SEATTLE</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98101</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROJ MGMNT HER</ServicesDesc>
        <CompensationAmt>1369509</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>3 FOLD COMMUNICATIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2031 K STREET</AddressLine1Txt>
            <CityNm>SACRAMENTO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95811</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MARKETING/COMMU</ServicesDesc>
        <CompensationAmt>1009707</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CHANGE HEALTHCARE RESOURCES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 572490</AddressLine1Txt>
            <CityNm>MURRAY</CityNm>
            <StateAbbreviationCd>UT</StateAbbreviationCd>
            <ZIPCd>84157</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SUPPORT/TECH</ServicesDesc>
        <CompensationAmt>660519</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>K&amp;L GATES LLP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 844255</AddressLine1Txt>
            <CityNm>BOSTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02284</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HLTH CARE CONSU</ServicesDesc>
        <CompensationAmt>495967</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>11</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>88482578</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>2458039</AllOtherContributionsAmt>
      <NoncashContributionsAmt>2453549</NoncashContributionsAmt>
      <TotalContributionsAmt>90940617</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICES</Desc>
        <TotalRevenueColumnAmt>113310729</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>113310729</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>113310729</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2848090</TotalRevenueColumnAmt>
        <ExclusionAmt>2848090</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>161474</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>161474</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>161474</TotalRevenueColumnAmt>
        <ExclusionAmt>161474</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>207166</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>207166</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>207166</TotalRevenueColumnAmt>
        <ExclusionAmt>207166</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>ALL OTHER PROGRAM REVENUES</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>2157414</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2157414</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>LITEHOUSE/FOOD SERVICE</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>123121</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>123121</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>SITKA PHYSICAL THERAPY</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>-566</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>-566</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>2279969</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>209748045</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>115591264</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>-566</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>3216730</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>174423</TotalAmt>
        <ProgramServicesAmt>174423</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>3974410</TotalAmt>
        <ManagementAndGeneralAmt>3974410</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>93873598</TotalAmt>
        <ProgramServicesAmt>67219766</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26653832</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>2589596</TotalAmt>
        <ProgramServicesAmt>1692102</ProgramServicesAmt>
        <ManagementAndGeneralAmt>897494</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>7792161</TotalAmt>
        <ProgramServicesAmt>5110928</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2681233</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>5454005</TotalAmt>
        <ProgramServicesAmt>3741542</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1712463</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>893814</TotalAmt>
        <ManagementAndGeneralAmt>893814</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>168333</TotalAmt>
        <ManagementAndGeneralAmt>168333</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>179735</TotalAmt>
        <ManagementAndGeneralAmt>179735</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>209234</TotalAmt>
        <ManagementAndGeneralAmt>209234</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>14230310</TotalAmt>
        <ProgramServicesAmt>5477391</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8752919</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>1501877</TotalAmt>
        <ProgramServicesAmt>88540</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1413337</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1508241</TotalAmt>
        <ProgramServicesAmt>683290</ProgramServicesAmt>
        <ManagementAndGeneralAmt>824951</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>5874003</TotalAmt>
        <ProgramServicesAmt>167783</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5706220</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>6443190</TotalAmt>
        <ProgramServicesAmt>1178392</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5264798</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>3793167</TotalAmt>
        <ProgramServicesAmt>1765497</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2027670</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>502156</TotalAmt>
        <ProgramServicesAmt>147487</ProgramServicesAmt>
        <ManagementAndGeneralAmt>354669</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>282497</TotalAmt>
        <ManagementAndGeneralAmt>282497</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>7937693</TotalAmt>
        <ManagementAndGeneralAmt>7937693</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>644458</TotalAmt>
        <ProgramServicesAmt>1534</ProgramServicesAmt>
        <ManagementAndGeneralAmt>642924</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL/OTHER SUPPLIES</Desc>
        <TotalAmt>12860863</TotalAmt>
        <ProgramServicesAmt>11524578</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1336285</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>ALL OTHER EXPENSES</Desc>
        <TotalAmt>11440163</TotalAmt>
        <ProgramServicesAmt>3209736</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8230427</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PATIENT TRAVEL</Desc>
        <TotalAmt>4725711</TotalAmt>
        <ProgramServicesAmt>4725711</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>ALLOCATION OF INDIRECT</Desc>
        <ProgramServicesAmt>43681330</ProgramServicesAmt>
        <ManagementAndGeneralAmt>-43681330</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>187053638</TotalAmt>
        <ProgramServicesAmt>150590030</ProgramServicesAmt>
        <ManagementAndGeneralAmt>36463608</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1059466</BOYAmt>
        <EOYAmt>2055606</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>42855914</BOYAmt>
        <EOYAmt>45788621</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>1291236</BOYAmt>
        <EOYAmt>7893419</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>14664739</BOYAmt>
        <EOYAmt>15916607</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1760976</BOYAmt>
        <EOYAmt>1728377</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>3067640</BOYAmt>
        <EOYAmt>2017966</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>156856105</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>58369571</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>85189915</BOYAmt>
        <EOYAmt>98486534</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>50819901</BOYAmt>
        <EOYAmt>53956370</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <IntangibleAssetsGrp>
        <EOYAmt>653334</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>3274004</BOYAmt>
        <EOYAmt>12211043</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>203983791</BOYAmt>
        <EOYAmt>240707877</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>24027741</BOYAmt>
        <EOYAmt>26641243</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>1530826</BOYAmt>
        <EOYAmt>3272185</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>5383816</BOYAmt>
        <EOYAmt>4367603</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <EOYAmt>8332810</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>30942383</BOYAmt>
        <EOYAmt>42613841</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>173041408</BOYAmt>
        <EOYAmt>198094036</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>173041408</BOYAmt>
        <EOYAmt>198094036</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>203983791</BOYAmt>
        <EOYAmt>240707877</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>22694407</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>1199813</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>1158408</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc11">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>78995531</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>72732068</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>79826081</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>80360294</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>90940617</CurrentTaxYearAmt>
        <TotalAmt>402854591</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>78995531</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>72732068</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>79826081</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>80360294</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>90940617</CurrentTaxYearAmt>
        <TotalAmt>402854591</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>402854591</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>135417</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1419473</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1172683</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1964437</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2848090</CurrentTaxYearAmt>
        <TotalAmt>7540100</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <CurrentTaxYearMinus4YearsAmt>5271</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>126099</CurrentTaxYearMinus3YearsAmt>
        <TotalAmt>131370</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <TotalSupportAmt>410526061</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>406295906</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.98130</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99200</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc3">
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>179735</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>179735</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE C, PART II-B, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>GENERALIZED FEES TO OUTSIDE LOBBYISTS FOR LOBBYING, GOVERNMENTAL RELATIONS FEDERAL AND STATE BUDGETARY AND HEALTHCARE MATTERS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc4">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>50819901</BeginningYearBalanceAmt>
        <ContributionsAmt>27267</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>3109202</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>53956370</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>39210262</BeginningYearBalanceAmt>
        <ContributionsAmt>9485626</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>2124013</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>50819901</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>35859723</BeginningYearBalanceAmt>
        <ContributionsAmt>49499</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>3301040</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>39210262</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>32879438</BeginningYearBalanceAmt>
        <ContributionsAmt>95213</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>2885072</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>35859723</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <ContributionsAmt>35046543</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-2167105</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>32879438</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>1.00000</BoardDesignatedBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>6651565</OtherCostOrOtherBasisAmt>
        <BookValueAmt>6651565</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>93654065</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>34342185</DepreciationAmt>
        <BookValueAmt>59311880</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>27109810</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>15665979</DepreciationAmt>
        <BookValueAmt>11443831</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>29440665</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>8361407</DepreciationAmt>
        <BookValueAmt>21079258</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>98486534</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>GOODWILL</Desc>
        <BookValueAmt>9549315</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>457 (B) DEFERRED COMP PLAN</Desc>
        <BookValueAmt>2661728</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>12211043</TotalBookValueOtherAssetsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>210004436</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>1199813</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>732084</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>1292805</OtherRevenueAmt>
      <RevenueNotReportedAmt>3224702</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>206779734</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>209234</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>2759077</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>2968311</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>209748045</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>184951808</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>732084</DonatedServicesUseFcltsAmt>
      <ExpensesNotReportedAmt>732084</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>184219724</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>209234</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>2624680</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>2833914</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>187053638</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>SEARHC IS ORGANIZED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AS A NONPROFIT, TAXEXEMPT ORGANIZATION. SEARHC IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. UNDER THE PROVISIONS OF SUBCHAPTER S OF THE INTERNAL REVENUE CODE, SITKA PHYSICAL THERAPY, LLC, DOES NOT PAY FEDERAL AND STATE CORPORATE INCOME TAXES ON ITS TAXABLE INCOME. INSTEAD, SEARHC, AS SOLE MEMBERSHIP INTEREST OWNER OF SITKA PHYSICAL THERAPY, LLC, IS LIABLE FOR FEDERAL AND STATE INCOME TAXES. MANAGEMENT HAS DEEMED THE ACTIVITIES OF SITKA PHYSICAL THERAPY AS UNRELATED BUSINESS INCOME AND WILL REPORT EARNINGS OF SITKA PHYSICAL THERAPY, LLC IN ITS FEDERAL 990-T. DURING FISCAL YEAR 2019, THE BOARD AUTHORIZED, AND MANAGEMENT CARRIED, OUT THE DISSOLUTION OF SITKA PHYSICAL THERAPY, LLC. SEARHC FOLLOWS THE PROVISIONS OF FASB ASC 740 INCOME TAXES, AND MANAGEMENT BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN. SEARHCS FEDERAL INCOME TAX RETURNS (FORM 990) ARE SUBJECT TO POSSIBLE EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE EXPIRATION OF THE RELATED STATUTE OF LIMITATIONS ON THOSE TAX RETURNS, WHICH, IN GENERAL, HAVE A THREE-YEAR STATUTE OF LIMITATIONS. MANAGEMENT HAS EVALUATED ITS TAX POSITIONS FOR THE YEARS ENDED SEPTEMBER 30, 2017 THROUGH 2019 IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES AND HAS DETERMINED IT HAS NO UNCERTAIN TAX POSITIONS REQUIRED TO BE DISCLOSED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>GAIN ON ACQUISITION 1,292,805</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XI, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT PROVISION 2,624,680 LOSS ON DISPOSAL 134,397</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XII, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT PROVISION 2,624,680</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc5">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CITY &amp; BOROUGH OF WRANGELL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 794</AddressLine1Txt>
          <CityNm>WRANGELL</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99929</ZIPCd>
        </USAddress>
        <CashGrantAmt>15000</CashGrantAmt>
        <PurposeOfGrantTxt>GENERAL FUNDING</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HEALING HAND FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3100 CHANNEL DRIVE STE 300</AddressLine1Txt>
          <CityNm>JUNEAU</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99801</ZIPCd>
        </USAddress>
        <RecipientEIN>920177320</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>47600</CashGrantAmt>
        <PurposeOfGrantTxt>PATIENT COPAYS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OUTER COAST</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 6573</AddressLine1Txt>
          <CityNm>SITKA</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99835</ZIPCd>
        </USAddress>
        <RecipientEIN>823228207</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>10500</CashGrantAmt>
        <PurposeOfGrantTxt>GENERAL FUNDING</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SEALASKA HERITAGE INSTITUTE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>0NE SEALASKA PLAZA SUITE 301</AddressLine1Txt>
          <CityNm>JUNEAU</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99801</ZIPCd>
        </USAddress>
        <RecipientEIN>920081844</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>5500</CashGrantAmt>
        <PurposeOfGrantTxt>GENERAL FUNDING</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SITKA COMMUNITY LAND TRUST</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 6461</AddressLine1Txt>
          <CityNm>SITKA</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99835</ZIPCd>
        </USAddress>
        <RecipientEIN>352292107</RecipientEIN>
        <CashGrantAmt>25000</CashGrantAmt>
        <PurposeOfGrantTxt>GENERAL FUNDING</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SOUTHEAST CONFERENCE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 21989</AddressLine1Txt>
          <CityNm>JUNEAU</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99801</ZIPCd>
        </USAddress>
        <RecipientEIN>920089029</RecipientEIN>
        <IRCSectionDesc>6</IRCSectionDesc>
        <CashGrantAmt>7500</CashGrantAmt>
        <PurposeOfGrantTxt>CONF SPONSORSHIP</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CHARLES CLEMENT</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3100 CHANNEL DRIVE SUITE 300</AddressLine1Txt>
          <CityNm>JUNEAU</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99801</ZIPCd>
        </USAddress>
        <CashGrantAmt>6500</CashGrantAmt>
        <PurposeOfGrantTxt>WATERFALL FOUNDATION</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>WRANGELL FIRE DEPARTMENT</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 794</AddressLine1Txt>
          <CityNm>WRANGELL</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99929</ZIPCd>
        </USAddress>
        <CashGrantAmt>30566</CashGrantAmt>
        <PurposeOfGrantTxt>EQUIPMENT PURCHASE</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>6</Total501c3OrgCnt>
      <TotalOtherOrgCnt>1</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PAGE 1, PART I, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING FISCAL YEAR 2019, SEARHC PROVIDED ASSISTANCE TO TWO ORGANIZATIONS. ORGANIZATIONS WERE ASKED TO PROVIDE NARRATIVE REPORTS ON THE USE AND IMPACT OF THE FUNDING RECEIVED.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc6">
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>false</SubstantiationRequiredInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHARLES CLEMENT</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>1018373</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>18500</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10279</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1047152</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DANIEL NEUMEISTER</PersonNm>
        <TitleTxt>SENIOR EXECUTIVE VP</TitleTxt>
        <BaseCompensationFilingOrgAmt>531435</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10356</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>4578</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>546369</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DANIEL HARRIS</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>415159</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>2462</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>417621</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBERT C WOLF</PersonNm>
        <TitleTxt>VP, CHIEF OPERATING</TitleTxt>
        <BaseCompensationFilingOrgAmt>330564</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10435</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10279</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>351278</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL DOUGLAS</PersonNm>
        <TitleTxt>VP, CHIEF LEGAL COUN</TitleTxt>
        <BaseCompensationFilingOrgAmt>321148</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8571</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10279</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>339998</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LEATHA MERCULIEFF</PersonNm>
        <TitleTxt>VP, EXECUTIVE ADMINI</TitleTxt>
        <BaseCompensationFilingOrgAmt>280943</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10884</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>4421</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>296248</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHELLE A KOONTZ</PersonNm>
        <TitleTxt>VP, CHIEF HUMAN RESO</TitleTxt>
        <BaseCompensationFilingOrgAmt>269275</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>13133</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>7424</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>289832</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID A BROWN</PersonNm>
        <TitleTxt>PHYSICIAN - ORTHOPED</TitleTxt>
        <BaseCompensationFilingOrgAmt>617717</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>11277</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>628994</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TERRENCE E BABB</PersonNm>
        <TitleTxt>PHYSICIAN - OB/GYN</TitleTxt>
        <BaseCompensationFilingOrgAmt>506425</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15603</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9152</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>531180</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LOREN E LAYBOURN</PersonNm>
        <TitleTxt>PHYSICIAN - RADIOLOG</TitleTxt>
        <BaseCompensationFilingOrgAmt>487587</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>18032</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10279</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>515898</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DANIEL SPARKS</PersonNm>
        <TitleTxt>PHYSICAN-SURGEON</TitleTxt>
        <BaseCompensationFilingOrgAmt>409938</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10769</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9683</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>430390</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUPRIYA GIANCHANDANI</PersonNm>
        <TitleTxt>PHYSICAN-ENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>358866</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>358866</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>HEALTH CLUB MEMBERSHIP INCLUDED IN VICE PRESIDENT EMPLOYMENT CONTRACTS AS HEALTH BENEFIT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>CHARLES CLEMENT 0 138,868 0 DANIEL NEUMEISTER 0 60,079 0 DANIEL HARRIS 0 35,581 0 MICHAEL DOUGLAS 0 12,929 0 LEATHA MERCULIEFF 0 45,698 0 MICHELLE A. KOONTZ 0 21,572 0</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc7">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CITY OF KAKE ALASKA</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>920038151</BondIssuerEIN>
        <BondIssuedDt>2013-08-16</BondIssuedDt>
        <IssuePriceAmt>10000000</IssuePriceAmt>
        <PurposeDesc>TO REFUND PREVIOUS BOND AND OTHER DEBT AND FOR CONSTRUCTION AND NEW</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>5632397</RetiredAmt>
        <TotalProceedsAmt>10000000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>41513</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>5314458</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>4644029</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>false</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>false</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K - PURPOSE OF ISSUE DESCRIPTION</FormAndLineReferenceDesc>
        <ExplanationTxt>CITY OF KAKE, ALASKA EQUIPMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K - ADDITIONAL INFORMATION</FormAndLineReferenceDesc>
        <ExplanationTxt>CITY OF KAKE, ALASKA TO REFUND PREVIOUS BOND AND OTHER DEBT AND FOR CONSTRUCTION AND NEW EQUIPMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="RetDoc8">
      <RealEstateCommercialGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>2453549</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FAIR MARKET VALUE</MethodOfDeterminingRevenuesTxt>
      </RealEstateCommercialGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc9">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>OUTPATIENT SERVICES - THIS PROGRAM PROVIDES PRIMARY HEALTH CARE SERVICES TO MOST COMMUNITIES OF SOUTHEAST ALASKA. THESE INCLUDE PHYSICIAN, MID-LEVEL, AND COMMUNITY HEALTH AIDE PROVIDERS AND TRAINING, ENVIRONMENTAL HEALTH, HEALTH PROMOTION AND PREVENTIVE SERVICES, FAMILY SERVICES, REMOTE MAINTENANCE SERVICES, AND EMERGENCY MEDICAL SERVICES. CLINIC LOCATIONS INCLUDE: ANGOON, HAINES, HYDABURG, JUNEAU, WRANGELL, KAKE, KASAAN, KLAWOCK, KLUKWAN, PELICAN, SITKA, HOONAH AND THORNE BAY. ADDITIONAL PRIMARY CARE AND/OR SPECIALIST SERVICES ARE PROVIDED IN PETERSBURG, SKAGWAY, AND YAKUTAT. IN FISCAL YEAR 2019, SEARHCS OUTPATIENT CLINICS PROVIDED SERVICES TO SOUTHEAST ALASKA RESIDENTS IN 158,757 OUTPATIENT VISITS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER PROGRAM SERVICES PROVIDED INCLUDE BEHAVIORAL HEALTH SERVICES INCLUDING RURAL SUBSTANCE ABUSE, RURAL MENTAL HEALTH, SOCIAL SERVICES, AND MENTAL HEALTH OUTPATIENT SERVICES; DENTAL SERVICES ARE PROVIDED TO MOST SOUTHEAST ALASKA COMMUNITIES. SERVICES INCLUDE ROUTINE ADULT AND CHILD DENTAL CARE, PATIENT EDUCATION, DENTAL DISEASE PREVENTION, EMERGENCY CARE AND ORTHODONTICS; REGIONAL PREVENTION SERVICES FOCUSING ON HEALTH LIFE STYLE CHANGES, EDUCATION AND PREVENTION; AND PURCHASED/REFERRED CARE PROGRAM WHICH PROVIDES ELIGIBLE BENEFICIARIES WITH ACCESS TO ACUTE, TERTIARY AND QUATERNARY CLINICAL CARE SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SEARHC GOVERNING BOARD DELEGATES AUTHORITY TO AN EXECUTIVE COMMITTEE COMPRISED OF THE BOARD PRESIDENT, VICE PRESIDENT, SECRETARY, TREASURER AND THREE MEMBERS AT LARGE. THIS COMMITTEE IS AUTHORIZED TO MAKE DECISIONS ON BEHALF OF THE GOVERNING BOARD, EXCEPT FOR HIRING/FIRING OF EXECUTIVE LEADERSHIP DECISIONS, WHICH THE ENTIRE BOARD MUST VOTE ON.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>SEARHCS FORM 990 WILL BE REVIEWED BY THE CHIEF FINANCIAL OFFICER PRIOR TO FILING. A COPY WILL BE PROVIDED TO THE BOARD AT THEIR NEXT REGULAR MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING AND ENFORCING THE CONFLICT OF INTEREST POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>SEARHC USES AN INDEPENDENT CONSULTANT TO CONDUCT AN ANNUAL SURVEY COMPARING JOBS/POSITIONS TO THOSE IN THE MARKET.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>NO DOCUMENTS AVAILABLE TO THE PUBLIC</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>GAIN ON ACQUISITION 1,292,805 BAD DEBT PROVISION -2,624,680 LOSS ON DISPOSAL -134,397 BAD DEBT PROVISION 2,624,680 TOTAL 1,158,408</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc10">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HEALING HAND FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3100 CHANNEL DRIVE SUITE 300</AddressLine1Txt>
          <CityNm>JUNEAU</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99801</ZIPCd>
        </USAddress>
        <EIN>920177320</EIN>
        <PrimaryActivitiesTxt>SECURE CHA</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AK</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12C</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SITKA PHYSICAL THERAPY</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>3100 CHANNEL DRIVE SUITE 300</AddressLine1Txt>
          <CityNm>JUNEAU</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99801</ZIPCd>
        </USAddress>
        <EIN>920171508</EIN>
        <PrimaryActivitiesTxt>PHYSICAL T</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AK</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>S CORP</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>-566</ShareOfTotalIncomeAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>