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            <State>KY</State>
            <ZIPCode>40206</ZIPCode>
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        </AddressOfContractor>
        <DescriptionOfServices>Billing Consultants</DescriptionOfServices>
        <Compensation>565355</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Siemens Healthcare Diagnostics Inc</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO Box 121102</AddressLine1>
            <City>Dallas</City>
            <State>TX</State>
            <ZIPCode>75312</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Medical Consultants</DescriptionOfServices>
        <Compensation>201158</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Quest Diagnostics</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>File Box 91514</AddressLine1>
            <City>Los Angelos</City>
            <State>CA</State>
            <ZIPCode>90074</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Medical Consultants</DescriptionOfServices>
        <Compensation>273300</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
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          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>2021 L St NW Suite 700</AddressLine1>
            <City>Washington</City>
            <State>DC</State>
            <ZIPCode>20037</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Legal Consultants</DescriptionOfServices>
        <Compensation>596131</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>9</NumberOfContractorsGT100K>
      <GovernmentGrants>56895140</GovernmentGrants>
      <AllOtherContributions>16649</AllOtherContributions>
      <TotalContributions>56911789</TotalContributions>
      <ProgramServiceRevenue>
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        <BusinessCode>624100</BusinessCode>
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        <RelatedOrExemptFunctionIncome>21700083</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
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        <RelatedOrExemptFunctionIncome>718540</RelatedOrExemptFunctionIncome>
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      <IncomeFromInvestBondProceeds>
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      </IncomeFromInvestBondProceeds>
      <RoyaltiesRevenue>
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      </RoyaltiesRevenue>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetRentalIncomeOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetGainOrLossInvestments>
      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
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      </NetIncomeFromGaming>
      <NetIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
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        <Description>Other</Description>
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      <TotalOtherRevenue>1129683</TotalOtherRevenue>
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      </TotalRevenue>
      <InfoInScheduleOPartIX>X</InfoInScheduleOPartIX>
      <GrantsToDomesticOrgs>
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        <ProgramServices>866450</ProgramServices>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
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        <ProgramServices>818656</ProgramServices>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
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      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
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        <ProgramServices>1221641</ProgramServices>
        <ManagementAndGeneral>297065</ManagementAndGeneral>
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      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>33140648</Total>
        <ProgramServices>26658207</ProgramServices>
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      <PensionPlanContributions>
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        <ProgramServices>1345867</ProgramServices>
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      <OtherEmployeeBenefits>
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        <ProgramServices>9946771</ProgramServices>
        <ManagementAndGeneral>1992473</ManagementAndGeneral>
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      <PayrollTaxes>
        <Total>0</Total>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
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        <ProgramServices>75</ProgramServices>
        <ManagementAndGeneral>286551</ManagementAndGeneral>
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      <FeesForServicesAccounting>
        <Total>0</Total>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
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        <ManagementAndGeneral>51431</ManagementAndGeneral>
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      <FeesForServicesProfFundraising>
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      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
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      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>10012931</Total>
        <ProgramServices>8818644</ProgramServices>
        <ManagementAndGeneral>1194287</ManagementAndGeneral>
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      <Advertising>
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        <ProgramServices>22244</ProgramServices>
        <ManagementAndGeneral>35481</ManagementAndGeneral>
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      <OfficeExpenses>
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        <ProgramServices>209014</ProgramServices>
        <ManagementAndGeneral>78938</ManagementAndGeneral>
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      <InformationTechnology>
        <Total>290258</Total>
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        <ManagementAndGeneral>30389</ManagementAndGeneral>
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      <Royalties>
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      </Royalties>
      <Occupancy>
        <Total>5929109</Total>
        <ProgramServices>5367445</ProgramServices>
        <ManagementAndGeneral>561664</ManagementAndGeneral>
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      <Travel>
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        <ManagementAndGeneral>1059371</ManagementAndGeneral>
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      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>0</Total>
      </ConferencesMeetings>
      <Interest>
        <Total>770610</Total>
        <ProgramServices>6906</ProgramServices>
        <ManagementAndGeneral>763704</ManagementAndGeneral>
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      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>6038328</Total>
        <ProgramServices>547690</ProgramServices>
        <ManagementAndGeneral>5490638</ManagementAndGeneral>
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      <Insurance>
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        <ManagementAndGeneral>593136</ManagementAndGeneral>
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        <Description>Special Projects</Description>
        <Total>1295944</Total>
        <ProgramServices>1081946</ProgramServices>
        <ManagementAndGeneral>213998</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>Supplies</Description>
        <Total>1801265</Total>
        <ProgramServices>1421979</ProgramServices>
        <ManagementAndGeneral>379286</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>GSA Warehouse</Description>
        <Total>2028882</Total>
        <ProgramServices>2028882</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Patient Transportation</Description>
        <Total>3272785</Total>
        <ProgramServices>3272526</ProgramServices>
        <ManagementAndGeneral>259</ManagementAndGeneral>
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      <AllOtherExpenses>
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        <ProgramServices>2835085</ProgramServices>
        <ManagementAndGeneral>1856354</ManagementAndGeneral>
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      <TotalFunctionalExpenses>
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        <ManagementAndGeneral>21367466</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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      <ReceivablesFromDisqualPersons>
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      <LandBuildingsEquipmentBasisNet>
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      <InvestmentsOtherSecurities>
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      <InvestmentsProgramRelated>
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      </InvestmentsProgramRelated>
      <IntangibleAssets>
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      <TotalAssets>
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      <AccountsPayableAccruedExpenses>
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      <DeferredRevenue>
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      <MortNotesPyblSecuredInvestProp>
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      <OtherLiabilities>
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      <TotalLiabilities>
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      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
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      <TemporarilyRestrictedNetAssets>
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        <EOY>7644621</EOY>
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      <TotalNetAssetsFundBalances>
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      <TotalLiabNetAssetsFundBalances>
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        <EOY>168076312</EOY>
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      <ReconcilationRevenueExpenses>-9195933</ReconcilationRevenueExpenses>
      <ReconciliationUnrealizedInvest>-116288</ReconciliationUnrealizedInvest>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementSeparate>X</FinancialStatementSeparate>
      </FSAuditedBasis>
      <AuditCommittee>true</AuditCommittee>
      <FederalGrantAuditRequired>true</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>true</FederalGrantAuditPerformed>
    </IRS990>
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        <Total>312589103</Total>
      </GiftsGrantsContribReceived170>
      <TaxRevLeviedForOrgBenefit170>
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      <ValueSrvcFcltsFurnishedByGovt>
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        <CurrentTaxYearMinus3Years>69887577</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>69702237</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>59565922</CurrentTaxYearMinus1Year>
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        <Total>312589103</Total>
      </Total170>
      <AmountsSubstContributorsTotal>0</AmountsSubstContributorsTotal>
      <PublicSupportTotal170>312589103</PublicSupportTotal170>
      <GrossInvestmentIncome170>
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        <CurrentTaxYearMinus1Year>309828</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>513648</CurrentTaxYear>
        <Total>2183538</Total>
      </GrossInvestmentIncome170>
      <NetUBI>
        <Total>0</Total>
      </NetUBI>
      <OtherIncome170>
        <CurrentTaxYearMinus2Years>825596</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>2186169</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>1129683</CurrentTaxYear>
        <Total>4141448</Total>
      </OtherIncome170>
      <TotalSupport>318914089</TotalSupport>
      <GrossReceiptsFromAdmissionsEtc>119150542</GrossReceiptsFromAdmissionsEtc>
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    </IRS990ScheduleA>
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      <ContributorInfo>
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        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
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        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
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      <CorrectionMade>false</CorrectionMade>
      <Volunteers>false</Volunteers>
      <PaidStaffOrManagement>false</PaidStaffOrManagement>
      <MediaAdvertisements>false</MediaAdvertisements>
      <MailingsMembers>false</MailingsMembers>
      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>false</GrantsOtherOrganizations>
      <DirectContactLegislators>false</DirectContactLegislators>
      <RalliesDemonstrations>false</RalliesDemonstrations>
      <OtherActivities>true</OtherActivities>
      <OtherActivitiesAmount>51431</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>51431</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>false</NotDescribedIn501c3>
      <Form4720Filed4912Tax>false</Form4720Filed4912Tax>
      <Form990ScheduleCPartIV>
        <Identifier>Part II-B, Line 1i</Identifier>
        <ReturnReference>Part II-B, Line 1i - Other Activities Description</ReturnReference>
        <Explanation>Maniilaq has a contract agreement with Adams Professional Services to provide lobbying services at the Federal, State and National level for capital clinic projects in our service area.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="12000229" softwareVersion="2012v2.0">
      <CurrentYear>
        <BeginningOfYearBalance>5654956</BeginningOfYearBalance>
        <Contributions>-80856</Contributions>
        <InvestmentEarningsOrLosses>89075</InvestmentEarningsOrLosses>
        <EndOfYearBalance>5663175</EndOfYearBalance>
      </CurrentYear>
      <CurrentYearMinus1Year>
        <BeginningOfYearBalance>5412809</BeginningOfYearBalance>
        <Contributions>115896</Contributions>
        <InvestmentEarningsOrLosses>126251</InvestmentEarningsOrLosses>
        <EndOfYearBalance>5654956</EndOfYearBalance>
      </CurrentYearMinus1Year>
      <CurrentYearMinus2Years>
        <BeginningOfYearBalance>5217037</BeginningOfYearBalance>
        <Contributions>57710</Contributions>
        <InvestmentEarningsOrLosses>138062</InvestmentEarningsOrLosses>
        <EndOfYearBalance>5412809</EndOfYearBalance>
      </CurrentYearMinus2Years>
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        <InvestmentEarningsOrLosses>183236</InvestmentEarningsOrLosses>
        <EndOfYearBalance>5217037</EndOfYearBalance>
      </CurrentYearMinus3Years>
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        <EndOfYearBalance>4869430</EndOfYearBalance>
      </CurrentYearMinus4Years>
      <BoardDesignatedEOYBalance>1.00000</BoardDesignatedEOYBalance>
      <EndowmentsHeldByUnrelatedOrgs>true</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>false</EndowmentsHeldByRelatedOrgs>
      <AreRelatedOrgsListedScheduleR>false</AreRelatedOrgsListedScheduleR>
      <Land>
        <OtherCostOrOtherBasis>814933</OtherCostOrOtherBasis>
        <BookValue>814933</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>143167043</OtherCostOrOtherBasis>
        <Depreciation>20608503</Depreciation>
        <BookValue>122558540</BookValue>
      </Buildings>
      <Equipment>
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        <Depreciation>8936077</Depreciation>
        <BookValue>2442312</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>3622751</OtherCostOrOtherBasis>
        <Depreciation>3213220</Depreciation>
        <BookValue>409531</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>126225316</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>Receivable due from MSLLC</Description>
        <BookValue>626709</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Notes Receivable - Maniilq Development</Description>
        <BookValue>13657801</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Interest Receivable</Description>
        <BookValue>29954</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Construction in Progress</Description>
        <BookValue>2101089</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Artwork</Description>
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      </OtherAssets>
      <TotalBookValueOtherAssets>17000638</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>Prepaid Deposits</Description>
        <Amount>97886</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
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      </OtherLiabilities>
      <OtherLiabilities>
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        <Amount>1080222</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Accrued Payroll &amp; Related liabilities</Description>
        <Amount>5028211</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>10460865</TotalOfAmounts>
      <FootnoteInPartXIII>X</FootnoteInPartXIII>
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      <NetUnrealizedGainsInvestments>-116288</NetUnrealizedGainsInvestments>
      <RevenueNotRptdF990>-116288</RevenueNotRptdF990>
      <RevenueSubtotal>80973743</RevenueSubtotal>
      <TotalRevenuePerForm990>80973743</TotalRevenuePerForm990>
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      <ExpensesSubtotal>90169676</ExpensesSubtotal>
      <TotalExpensesPerForm990>90169676</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIII>
        <Identifier>Part X</Identifier>
        <ReturnReference>Part X : FIN48 Footnote</ReturnReference>
        <Explanation>The Association is exempt from income taxes as a non-profit corporation under Section 501(c)(3) of the Internal Revenue Code and accordingly, no provision for income taxes has been included in the accompanying financial statements.Although Maniilaq Association is exempt from federal income taxes, any income derived from unrelated business activities is subject to the requirements of filing Federal Income Tax Form 990-T and a tax liability may be determined on these activities. Maniilaq's policy is to report interest and penalties associated with income taxes as other expense. With few exceptions, Maniilaq is not subject to audit of its tax returns prior to September 30, 2010. As of September 30, 2013 there were no accrued interest, penalties, or uncertain tax positions or unrecognized tax benefits for which management believes it is reasonably possible that the total amounts of tax contingencies will significantly increase or decrease within 12 months of the reporting date.</Explanation>
      </Form990ScheduleDPartXIII>
      <Form990ScheduleDPartXIII>
        <Identifier>Part V, Line 4</Identifier>
        <ReturnReference>Part V, Line 4: Intended uses of the endowment fund.</ReturnReference>
        <Explanation>The intended use of the Organization's endowment fund interest earnings are for scholarship purposes for tribal members.The fund itself is restricted for use for operational purposes.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH" softwareId="12000229" softwareVersion="2012v2.0">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent100>X</Pcent100>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent200D>X</Pcent200D>
      <FreeDiscCareMedicallyIndigent>false</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>false</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>false</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>false</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>false</ReportPublicallyAvailable>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>36376</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>2904945</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>2904945</CostOfCareReimbursedByMedicare>
      <CostingMethodologyUsed>
        <Other>X</Other>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>false</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>12</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>12</FacilityNumber>
        <Name>
          <BusinessNameLine1>Point Hope Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1729 Qalugi Ave</AddressLine1>
          <City>Point Hope</City>
          <State>AK</State>
          <ZIPCode>99766</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>11</FacilityNumber>
        <Name>
          <BusinessNameLine1>Maniilaq Health Center</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>436 5th Ave</AddressLine1>
          <City>Kotzebue</City>
          <State>AK</State>
          <ZIPCode>99752</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>10</FacilityNumber>
        <Name>
          <BusinessNameLine1>Kivalina Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 8</AddressLine1>
          <City>Kivalina</City>
          <State>AK</State>
          <ZIPCode>99750</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>9</FacilityNumber>
        <Name>
          <BusinessNameLine1>Shungnak Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 80</AddressLine1>
          <City>Shungnak</City>
          <State>AK</State>
          <ZIPCode>99737</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>8</FacilityNumber>
        <Name>
          <BusinessNameLine1>Selawik Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 180</AddressLine1>
          <City>Selawik</City>
          <State>AK</State>
          <ZIPCode>99770</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>7</FacilityNumber>
        <Name>
          <BusinessNameLine1>Noorvik Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 189</AddressLine1>
          <City>Noorvik</City>
          <State>AK</State>
          <ZIPCode>99763</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>6</FacilityNumber>
        <Name>
          <BusinessNameLine1>Noatak Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 90</AddressLine1>
          <City>Noatak</City>
          <State>AK</State>
          <ZIPCode>99751</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>5</FacilityNumber>
        <Name>
          <BusinessNameLine1>Kobuk Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 3</AddressLine1>
          <City>Kobuk</City>
          <State>AK</State>
          <ZIPCode>99750</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>4</FacilityNumber>
        <Name>
          <BusinessNameLine1>Kiana Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 130</AddressLine1>
          <City>Kiana</City>
          <State>AK</State>
          <ZIPCode>99749</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>3</FacilityNumber>
        <Name>
          <BusinessNameLine1>Deering Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 23</AddressLine1>
          <City>Deering</City>
          <State>AK</State>
          <ZIPCode>99736</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>2</FacilityNumber>
        <Name>
          <BusinessNameLine1>Buckland Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 9</AddressLine1>
          <City>Buckland</City>
          <State>AK</State>
          <ZIPCode>99727</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>Ambler Clinic</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO Box 110</AddressLine1>
          <City>Ambler</City>
          <State>AK</State>
          <ZIPCode>99786</ZIPCode>
        </Address>
        <WebsiteAddress>www.maniilaq.org</WebsiteAddress>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <FacilityReportingGroup>a</FacilityReportingGroup>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Maniilaq Health Center</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>11</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <NeedsAssessmentConducted>13</NeedsAssessmentConducted>
        <TakeIntoAccount>false</TakeIntoAccount>
        <OtherFacilities>false</OtherFacilities>
        <CHNAWidelyAvailable>false</CHNAWidelyAvailable>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <AllNeedsAddressed>false</AllNeedsAddressed>
        <OrganizationIncurExciseTax>false</OrganizationIncurExciseTax>
        <FileForm4720ReportExciseTax>false</FileForm4720ReportExciseTax>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>100.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <InsuranceStatus>X</InsuranceStatus>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <PermitReportToCreditAgency>X</PermitReportToCreditAgency>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <DocumentedDetermination>X</DocumentedDetermination>
        <OtherActionsTaken>X</OtherActionsTaken>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>true</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>a</BusinessNameLine1>
        </HospitalFacilityName>
        <CHNAConducted>true</CHNAConducted>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <NeedsAssessmentConducted>13</NeedsAssessmentConducted>
        <TakeIntoAccount>false</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>false</CHNAWidelyAvailable>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <AllNeedsAddressed>false</AllNeedsAddressed>
        <OrganizationIncurExciseTax>false</OrganizationIncurExciseTax>
        <FileForm4720ReportExciseTax>false</FileForm4720ReportExciseTax>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>100.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <InsuranceStatus>X</InsuranceStatus>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <PermitReportToCreditAgency>X</PermitReportToCreditAgency>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <DocumentedDetermination>X</DocumentedDetermination>
        <OtherActionsTaken>X</OtherActionsTaken>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>true</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>1</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Utuqqunaat Inaat-Long Term Care Facility</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>PO Box 256</AddressLine1>
            <City>Kotzebue</City>
            <State>AK</State>
            <ZIPCode>99752</ZIPCode>
          </Address>
          <FacilityType>A long term care nursing wing co-located with the Maniilaq Health Center in Kotzebue, AK. The Elder</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - States Where Community Benefit Report Filed</ReturnReference>
        <Explanation>AK</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Explanation Of How Organization Furthers Its Exempt Purpose</ReturnReference>
        <Explanation>Maniilaq is the sole provider of Health and Social Services in the region. New and expanded facilities provide space for health services expansions and improved services. (i.e. New skilled nursing facilities, physical therapy suite, expanded/specialty services).</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Community Information</ReturnReference>
        <Explanation>Serve residents in 12 communities of large geographically remote region. Each of the 12 clinics are located in each community. Maniilaq utilizes itinerate providers. Maniilaq funded patient travel to allow correct level of care is significant portion of budget.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Patient Education of Eligibility for Assistance</ReturnReference>
        <Explanation>Patients are informed during the time of Registration.Financial counselors assist with applications for Medicaid/Medicare.Sliding fee scale for eligibility (income based).</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Needs Assessment</ReturnReference>
        <Explanation>The Board of Directors is a community based board, which meets every 2 months.Patient Surveys.Health indicators such as in Regional Profile.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 11</Identifier>
        <ReturnReference>Part V, Line 22 - Charge Patients Amount Equal Gross Charge for Services</ReturnReference>
        <Explanation>Non-Beneficiary/Beneficiary patients without a payer and who are ineligible for discounted services are billed for full charge of services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 22 - Charge Patients Amount Equal Gross Charge for Services</ReturnReference>
        <Explanation>Non-Beneficiary/Beneficiary patients without a payer and who are ineligible for discounted services are billed for full charge of services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 11</Identifier>
        <ReturnReference>Part V, Line 20d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>Charges established or published using standard charge rates adjusted for geological differences. Sliding fee schedule used based on percentage of FPL. Native beneficiary status for adjusting charges to qualified Alaskan Natives/ American Indians.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 20d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>Charges established or published using standard charge rates adjusted for geological differences. Sliding fee schedule used based on percentage of FPL. Native beneficiary status for adjusting charges to qualified Alaskan Natives/ American Indians.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 11</Identifier>
        <ReturnReference>Part V, Line 18e - Other Actions Took Before Any Collection Actions</ReturnReference>
        <Explanation>Send notice with bills/invoices.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 18e - Other Actions Took Before Any Collection Actions</ReturnReference>
        <Explanation>Send notice with bills/invoices.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 11</Identifier>
        <ReturnReference>Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why</ReturnReference>
        <Explanation>The needs assessment has only recently been put into a report and there has not been enough time to address all of the changes.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why</ReturnReference>
        <Explanation>The needs assessment has only recently been put into a report and there has not been enough time to address all of the changes.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>Ambler ClinicBuckland ClinicDeering ClinicKiana ClinicKobuk ClinicNoatak ClinicNoorvik ClinicSelawik ClinicShungnak ClinicKivalina ClinicPoint Hope Clinic</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part III, Line 8 - Explanation Of Shortfall As Community Benefit</ReturnReference>
        <Explanation>Maniilaq files the Method E cost report that utilizes an ancillary cost ratio to develop costs for Medicare apportionment.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part III, Line 4 - Bad Debt Expense</ReturnReference>
        <Explanation>Accounts receivable include amounts from Grantors and third party payers, primarily insurance companies. Accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable noncollectable amounts through a provision for bad debt expense and an adjustment to a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has issued collection efforts are written off through a charge to the valuation allowance and a credit to accounts receivable.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="IRS990ScheduleI" softwareId="12000229" softwareVersion="2012v2.0">
      <RecordsMaintained>true</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Shungnak IRA</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 73064</AddressLine1>
          <City>Shungnak</City>
          <State>AK</State>
          <ZIPCode>99773</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>307849</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Noorvik IRA Council</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 209</AddressLine1>
          <City>Noorvik</City>
          <State>AK</State>
          <ZIPCode>99763</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>67141</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Native Village of Selawik</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>59 North Tundra</AddressLine1>
          <City>Selawik</City>
          <State>AK</State>
          <ZIPCode>99770</ZIPCode>
        </AddressUS>
        <EINOfRecipient>920049770</EINOfRecipient>
        <AmountOfCashGrant>56496</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiative</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Native Village of Pt Hope</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 109</AddressLine1>
          <City>Point Hope</City>
          <State>AK</State>
          <ZIPCode>99760</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>40450</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Native Village of Noatak</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 89</AddressLine1>
          <City>Noatak</City>
          <State>AK</State>
          <ZIPCode>99761</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>34300</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Native Village of Kotzebue</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 296</AddressLine1>
          <City>Kotzebue</City>
          <State>AK</State>
          <ZIPCode>99752</ZIPCode>
        </AddressUS>
        <EINOfRecipient>920060128</EINOfRecipient>
        <AmountOfCashGrant>86075</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Native Village of Ambler</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 47</AddressLine1>
          <City>Ambler</City>
          <State>AK</State>
          <ZIPCode>99786</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>34100</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Kobuk Traditional Coun</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 51039</AddressLine1>
          <City>Kobuk</City>
          <State>AK</State>
          <ZIPCode>99751</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>27250</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Kivalina IRA Council</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 50051</AddressLine1>
          <City>Kivalina</City>
          <State>AK</State>
          <ZIPCode>99750</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>69480</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Kiana Traditional Council</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 69</AddressLine1>
          <City>Kiana</City>
          <State>AK</State>
          <ZIPCode>99749</ZIPCode>
        </AddressUS>
        <EINOfRecipient>920061730</EINOfRecipient>
        <AmountOfCashGrant>33100</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Deering IRA Council</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 36089</AddressLine1>
          <City>Deering</City>
          <State>AK</State>
          <ZIPCode>99736</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>37758</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Buckland IRA Council</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>10 Virginia Ave</AddressLine1>
          <City>Buckland</City>
          <State>AK</State>
          <ZIPCode>99727</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>33850</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Village Initiatives</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>12</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>0</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Tribal Tuition Assistance</TypeOfGrant>
        <NumberOfRecipients>118</NumberOfRecipients>
        <AmountOfCashGrant>204524</AmountOfCashGrant>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Tribal TANF Clients Public</TypeOfGrant>
        <NumberOfRecipients>185</NumberOfRecipients>
        <AmountOfCashGrant>302571</AmountOfCashGrant>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Tribal Childcare Assistance</TypeOfGrant>
        <NumberOfRecipients>30</NumberOfRecipients>
        <AmountOfCashGrant>259366</AmountOfCashGrant>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Administrative Rental Assistance</TypeOfGrant>
        <NumberOfRecipients>1</NumberOfRecipients>
        <AmountOfCashGrant>52195</AmountOfCashGrant>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIV>
        <Identifier>Grantmaker's Description of How Grants are Used</Identifier>
        <Explanation>The planning department applies for grant awards that may benefit programs or individuals within the Maniilaq service area. All grants are provisioned and monitored in accordance with the grant agreement and compliance requirements.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="12000229" softwareVersion="2012v2.0">
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>true</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
        <NamePerson>Wanda Dufrene</NamePerson>
        <Title>Physician</Title>
        <BaseCompensationFilingOrg>216852</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>12822</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>229674</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ronald Shemenski</NamePerson>
        <Title>Physician</Title>
        <BaseCompensationFilingOrg>273075</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>273075</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Patricia Clancy</NamePerson>
        <Title>Physician</Title>
        <BaseCompensationFilingOrg>261664</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>17736</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>279400</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Nathan Kotch Jr</NamePerson>
        <Title>Vice President</Title>
        <BaseCompensationFilingOrg>250040</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>75000</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>159988</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>485028</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Mary Gwayi-Chore</NamePerson>
        <Title>Physician</Title>
        <BaseCompensationFilingOrg>212625</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>212625</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Lucy Nelson</NamePerson>
        <Title>Finance Direct.</Title>
        <BaseCompensationFilingOrg>183774</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>54841</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>238615</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ian Erlich</NamePerson>
        <Title>President &amp; CEO</Title>
        <BaseCompensationFilingOrg>261664</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>158644</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>102641</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>522949</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Erick Torres-Semprit</NamePerson>
        <Title>Physician</Title>
        <BaseCompensationFilingOrg>209231</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>34632</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>243863</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Barbara Janitscheck</NamePerson>
        <Title>Tribal Admin.</Title>
        <BaseCompensationFilingOrg>166368</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>220047</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>386415</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="12000229" softwareVersion="2012v2.0">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Ian Erlich</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Former Off.</Relationship>
        <AmountOfTransaction>158644</AmountOfTransaction>
        <DescriptionOfTransaction>Contract Services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="12000229" softwareVersion="2012v2.0">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>Upon request</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>In accordance with personnel policy, each I'd has a range and step amount for experience and the HR department determines the amount for each via executive committee meetings.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15a</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</ReturnReference>
        <Explanation>In accordance with personnel policy, each I'd has a range and step amount for experience and the HR department determines the amount for each via executive committee meetings.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>Officers, Directors and employees are required to review annually. Any violations are reported to the HR department and dealt with in that manner.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11b: Form 990 Review Process</ReturnReference>
        <Explanation>The return is reviewed by the Executive Director before it is filed.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="12000229" softwareVersion="2012v2.0">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Tupqich Elder Apartment Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>PO Box 256</AddressLine1>
          <City>Kotzebue</City>
          <State>AK</State>
          <ZIPCode>99752</ZIPCode>
        </AddressUS>
        <EIN>200736815</EIN>
        <PrimaryActivities>Elder Housing</PrimaryActivities>
        <LegalDomicileState>AK</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Maniilaq Association</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Maniilaq Services LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1700 Seventh Avenue Suite 2100</AddressLine1>
          <City>Seattle</City>
          <State>WA</State>
          <ZIPCode>98101</ZIPCode>
        </AddressUS>
        <EIN>770671852</EIN>
        <PrimaryActivity>8a contracting</PrimaryActivity>
        <LegalDomicileState>AK</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
        <PercentageOwnership>0.49000</PercentageOwnership>
      </Form990ScheduleRPartIII>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>false</DividendsRelatedOrganization>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Maniilaq Services LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>m</TransactionType>
        <AmountInvolved>810221</AmountInvolved>
        <MethodOfAmtDetermination>Standard rate</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>