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        <PersonNm>JENNIFER BURKHART</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JOHNNY TUREAUD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MARI KAPTAIN-DAHLEN</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JAN ANDERSON CPA MBA</PersonNm>
        <TitleTxt>CFO</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL PIPLANI MD</PersonNm>
        <TitleTxt>CMO</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID FALDMO PA</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BRENDA HAUSMAN-MILLER MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>RYAN BALLER DDS</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KRISTI WALZ MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>GARY HATTAN MD</PersonNm>
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        <OtherCompensationAmt>36895</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DANIELLE ROSENKRANS MD</PersonNm>
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        <OtherCompensationAmt>26129</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ANN PICK</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26840</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MOLLY EARLEYWINE</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29567</OtherCompensationAmt>
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      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
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      <IndivRcvdGreaterThan100KCnt>25</IndivRcvdGreaterThan100KCnt>
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      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>INCONCERT</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>CARE INC</AddressLine1Txt>
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            <StateAbbreviationCd>IA</StateAbbreviationCd>
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        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>BKD</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>LLP</AddressLine1Txt>
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          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>SIOUXLAND MEDICAL</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>ED FOUNDATION</AddressLine1Txt>
            <CityNm>SIOUX CITY</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>HR</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>CONSTRUCTION</AddressLine1Txt>
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          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>QUEST</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>DIAGNOSTICS</AddressLine1Txt>
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          </USAddress>
        </ContractorAddress>
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      <GovernmentGrantsAmt>4527728</GovernmentGrantsAmt>
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      <NoncashContributionsAmt>459810</NoncashContributionsAmt>
      <TotalContributionsAmt>4731092</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>18881510</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>18881510</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>149971</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>149971</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>EHR INCENTIVE REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>624750</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>624750</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>19656231</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>16927</TotalRevenueColumnAmt>
        <ExclusionAmt>16927</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
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      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>854</TotalRevenueColumnAmt>
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      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
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      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
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      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>131878</ProgramServicesAmt>
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      <GrantsToDomesticIndividualsGrp>
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        <ProgramServicesAmt>68765</ProgramServicesAmt>
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      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
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      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>1000938</ProgramServicesAmt>
        <ManagementAndGeneralAmt>362066</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>8426726</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1868567</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>329620</ProgramServicesAmt>
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        <ProgramServicesAmt>888204</ProgramServicesAmt>
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        <ProgramServicesAmt>641337</ProgramServicesAmt>
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      <FeesForServicesManagementGrp>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>37303</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>127079</ManagementAndGeneralAmt>
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      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
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        <ProgramServicesAmt>1230707</ProgramServicesAmt>
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        <ProgramServicesAmt>730</ProgramServicesAmt>
        <ManagementAndGeneralAmt>112786</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>336981</ProgramServicesAmt>
        <ManagementAndGeneralAmt>217923</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>34089</ProgramServicesAmt>
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        <ProgramServicesAmt>227204</ProgramServicesAmt>
        <ManagementAndGeneralAmt>53367</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>39841</ProgramServicesAmt>
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        <ProgramServicesAmt>131217</ProgramServicesAmt>
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        <ProgramServicesAmt>4101</ProgramServicesAmt>
        <ManagementAndGeneralAmt>266922</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>33139</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8333</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>2563055</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>347521</ProgramServicesAmt>
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        <ProgramServicesAmt>49139</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28423</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>22854</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
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        <ManagementAndGeneralAmt>9029</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>3952811</ManagementAndGeneralAmt>
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        <EOYAmt>103860</EOYAmt>
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        <EOYAmt>6917998</EOYAmt>
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        <EOYAmt>1487836</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>201975</EOYAmt>
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        <EOYAmt>75390</EOYAmt>
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        <EOYAmt>11476143</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>0</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>1000</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
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        <ExplanationTxt>OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE IOWA PRIMARY CARE ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16657</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>213265</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANN PICK</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>149209</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>23400</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>5394</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8629</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18211</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>204843</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MOLLY EARLEYWINE</PersonNm>
        <TitleTxt>PHYSICIAN ASSISTANT</TitleTxt>
        <BaseCompensationFilingOrgAmt>135849</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>4400</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>9146</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7360</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22207</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>178962</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID FALDMO PA</PersonNm>
        <TitleTxt>QUALITY DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>197858</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>30200</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>10107</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12079</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>26129</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>276373</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRENDA HAUSMAN-MILLER MD</PersonNm>
        <TitleTxt>CO-DENTAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>179292</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>12120</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>4708</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9978</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25991</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>232089</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RYAN BALLER DDS</PersonNm>
        <TitleTxt>CO-DENTAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>168996</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>14120</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>10898</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9797</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24402</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>228213</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART 1, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>NON-FIXED PAYMENTS THE BONUSES PAID TO EMPLOYEES ARE COMPUTED BASED ON PERFORMANCE, SUBJECT TO THE DISCRETION OF THE CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
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        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>WOODBURY COUNTY IOWA</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>426005221</BondIssuerEIN>
        <BondIssuedDt>2007-09-25</BondIssuedDt>
        <IssuePriceAmt>7000000</IssuePriceAmt>
        <PurposeDesc>CONSTRUCTION OF NEW FACILITY</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
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        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>7000000</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>100000</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>6900000</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2009</SubstantialCompletionYr>
        <CurrentRefundingInd>false</CurrentRefundingInd>
        <AdvanceRefundingInd>false</AdvanceRefundingInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>true</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>true</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>WELLS FARGO</BusinessNameLine1Txt>
        </HedgeProviderName>
        <TermOfHedgePct>20.</TermOfHedgePct>
        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K, PART IV, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>NO REBATE DUE: THE COMPUTATION WAS PERFORMED AS OF 11/25/2012.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="IRS990ScheduleM">
      <WorksOfArtGrp />
      <ArtHistoricalTreasuresGrp />
      <ArtFractionalInterestGrp />
      <BooksAndPublicationsGrp />
      <ClothingAndHouseholdGoodsGrp />
      <CarsAndOtherVehiclesGrp />
      <BoatsAndPlanesGrp />
      <IntellectualPropertyGrp />
      <SecuritiesPubliclyTradedGrp />
      <SecuritiesCloselyHeldStockGrp />
      <SecurPrtnrshpTrustIntrstsGrp />
      <SecuritiesMiscellaneousGrp />
      <QualifiedContribHistStructGrp />
      <QualifiedContribOtherGrp />
      <RealEstateResidentialGrp />
      <RealEstateCommercialGrp />
      <RealEstateOtherGrp />
      <CollectiblesGrp />
      <FoodInventoryGrp />
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>3</ContributionCnt>
        <NoncashContributionsRptF990Amt>459810</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <TaxidermyGrp />
      <HistoricalArtifactsGrp />
      <ScientificSpecimensGrp />
      <ArchaeologicalArtifactsGrp />
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE M, PART I, LINE 20, COLUMN (B)</FormAndLineReferenceDesc>
        <ExplanationTxt>NUMBER OF CONTRIBUTIONS: THE ORGANIZATION RECEIVED DRUGS AND MEDICAL SUPPLIES FROM 3 DIFFERENT DONORS THROUGHOUT THE YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION'S MISSION: SIOUXLAND COMMUNITY HEALTH CENTER IS A NONPROFIT ORGANIZATION DEDICATED TO MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY AND SUPPORTS THE PHILOSOPHY OF THE PATIENT-CENTERED MEDICAL HOME. OUR VALUES INCLUDE WELCOMING, EXCELLENCE, COLLABORATION, ACCOUNTABILITY, RESPECT AND EMPATHY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>NEW MEDICAL CLINIC: DURING FY 2015, SIOUXLAND COMMUNITY HEALTH CENTER OPENED A NEW MEDICAL CLINIC TO PROVIDE A WIDE RANGE OF PRIMARY AND WALK-IN URGENT CARE SERVICES WITH INTERPRETERS AND FINANCIAL COUNSELORS ON-SITE IN SOUTH SIOUX CITY, NE. THESE SERVICES INCLUDE VACCINATIONS, SCHOOL AND SPORTS PHYSICALS, ADULT HEALTH EXAMS, AND WALK-IN URGENT CARE FOR ACUTE ILLNESS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAM SERVICES: SIOUXLAND COMMUNITY HEALTH CENTER (SCHC) IS DEDICATED TO MEETING THE HEALTHCARE NEEDS OF THE SIOUXLAND AREA AND IS A LEVEL THREE PATIENT CENTERED MEDICAL HOME. SCHC OFFERS THE FOLLOWING SERVICES: PRIMARY AND SPECIALTY MEDICAL SERVICES, LABORATORY, RADIOLOGY, HIV/AIDS AND HEPATITIS CARE, BEHAVIORAL HEALTH, PHARMACY, AND DENTAL SERVICES. SCHC PROVIDES FINANCIAL ASSISTANCE TO THE UNINSURED AND UNDERINSURED TO ELIMINATE ACCESS BARRIERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAM SERVICE ACTIVITY #1: LABORATORY SIOUXLAND COMMUNITY HEALTH CENTER CURRENTLY CONDUCTS APPROXIMATELY 68% OF ITS LABORATORY TESTS ONSITE AND IS A MODERATE COMPLEX LABORATORY. FOR THOSE TESTS NOT PERFORMED ONSITE, THEY ARE SENT TO A REFERENCE LABORATORY WHERE THE MAJORITY OF TEST RESULTS ARE RETURNED WITHIN 24 HOURS. CONDUCTING THE MAJORITY OF TESTS ONSITE ENSURES RAPID TURNAROUND FOR DIAGNOSIS AND MONITORING OF CHRONIC MEDICAL CONDITIONS. THE LABORATORY WAS ACCREDITED BY CLIA FOR THE YEAR ENDING 1/31/16, THE LABORATORY PERFORMED 324,881 TESTS. RADIOLOGY SCHC ALSO CONDUCTS RADIOLOGY SERVICES. IT PERFORMED 3,909 EXAMS FOR THE YEAR ENDING 1/31/16. HIV/AIDS AND HEPATITIS THE HIV TEAM SERVES THE TRI-STATE SIOUXLAND AREA, AS WELL AS 20 NORTHWEST IOWA COUNTIES, 3 COUNTIES IN NEBRASKA, AND ONE COUNTY IN SOUTH DAKOTA. APPROXIMATELY 49% OF PATIENTS RECEIVING HIV/AIDS CARE LIVE IN RURAL AREAS. IN ADDITION TO MEDICAL CARE, THE HIV TEAM COORDINATES DENTAL CARE, CASE MANAGEMENT, TRANSPORTATION, AND HOUSING ASSISTANCE. FOR THE FISCAL YEAR ENDING 1/31/16, THE HIV TEAM SERVED 159 PATIENTS. FINANCIAL SERVICES TO ENSURE PATIENTS HAVE ACCESS TO CARE AT AN AFFORDABLE RATE, SCHC OFFERS A SLIDING FEE DISCOUNT TO PATIENTS BASED ON INCOME ELIGIBILITY AND ACCEPTS MEDICAID (TITLE 19), MEDICARE (TITLE 18), HAWK-I (STATE CHIP) AND MOST PRIVATE INSURANCES. IN 2015, 21% OF PATIENTS RECEIVING CARE WERE UNINSURED, 45% HAD COVERAGE BY MEDICAID/HAWK-I, 8% HAD MEDICARE COVERAGE, AND 26% HAD COVERAGE BY OTHER PAYERS. SCHC EMPLOYED FOUR CERTIFIED APPLICATION COUNSELORS TO ASSIST INDIVIDUALS WITH ENROLLMENT IN THE HEALTH INSURANCE EXCHANGE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAM SERVICE ACTIVITY #2: THE SCHC PHARMACY ALSO PARTICIPATES IN OTHER PHARMACEUTICAL ASSISTANCE PROGRAMS TO ENSURE PATIENTS HAVE ACCESS TO NEEDED PRESCRIPTION DRUGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>SIGNIFICANT CHANGES: THE FOLLOWING SIGNIFICANT CHANGES WERE MADE TO THE ORGANIZATION'S BYLAWS DURING THE FISCAL YEAR: 4.3 GOVERNING BODY, COMPOSITION UNITYPOINT ST. LUKE'S AND MERCY MEDICAL CENTER WILL EACH BE ENTITLED TO ONE PERMANENT POSITION ON THE BOARD. 5.2 OFFICERS, TERM OF OFFICE OFFICERS MAY BE RE-ELECTED TO THE SAME OFFICE FOR ONE ADDITIONAL CONSECUTIVE TWO-YEAR TERM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CEO AND CFO REVIEW THE RETURN BEFORE IT IS PRESENTED TO THE FINANCE COMMITTEE. THE FINANCE COMMITTEE APPROVES THE RETURN, AND THE FINANCE COMMITTEE CHAIR MAKES A RECOMMENDATION TO THE BOARD FOR APPROVAL OF THE FORM 990 FOR FILING WITH THE IRS. BOARD MEMBERS RECEIVE THE FORM 990 AS HARD COPIES (MAILED OR HAND-DELIVERED) OR ELECTRONIC FILES (SENT VIA E-MAIL).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST POLICY: A CONFLICT OF INTEREST POLICY IS STATED IN THE EMPLOYEE HANDBOOK. PER THE BYLAWS, IF A QUESTION CONCERNING A CONFLICT OF INTEREST FOR ANY DIRECTOR IS RAISED, A WRITTEN SECRET BALLOT MAY BE USED BY THE REMAINING DIRECTORS TO DETERMINE IF SUCH CONFLICT OF INTEREST EXISTS. SHOULD A CONFLICT OF INTEREST, PECUNIARY OR OTHERWISE, BE DETERMINED FOR ANY DIRECTOR, SUCH DIRECTOR SHALL BE EXCLUDED FROM VOTING ON THAT SUBJECT MATTER. A SIMPLE, AFFIRMATIVE MAJORITY OF THOSE PRESENT SHALL RULE. IN ALL EVENTS, A DIRECTOR SHALL DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINES 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION REVIEW THE CEO'S COMPENSATION WAS EVALUATED IN 2015 BY THE EXECUTIVE BOARD OF DIRECTORS USING A COMPREHENSIVE CEO PERFORMANCE EVALUATION TOOL. THE EXECUTIVE BOARD ASSESSED THE CEO'S INDIVIDUAL PERFORMANCE, THE ORGANIZATION'S PERFORMANCE, AND WHETHER THE CEO ACCOMPLISHED THE MUTUALLY AGREED UPON OBJECTIVES FOR THE FISCAL YEAR BEING REVIEWED. THE HR DIRECTOR CONDUCTS AN IN-DEPTH SALARY ANALYSIS ON A BI-ANNUAL BASIS WITH A CURSORY ANALYSIS DURING THE ALTERNATE YEARS. THE DATA USED IS OBTAINED LOCALLY, REGIONALLY, AND NATIONALLY. THIS ANALYSIS IS COMPLIED AND A RECOMMENDATION IS TAKEN TO THE EXECUTIVE BOARD. THE CEO'S ANNUAL PERFORMANCE EVALUATION IS CALCULATED BY THE EXECUTIVE BOARD TO DETERMINE THE CURRENT YEAR SALARY, AND THE SALARY ANALYSIS IS COMPARED TO ENSURE THAT THE SALARY IS APPROPRIATE FOR THE POSITION AND PERFORMANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE PROVIDED TO INQUIRING PARTIES UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>