﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2013v3.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2014-11-17T09:51:13-06:00</ReturnTs>
    <TaxPeriodEndDt>2013-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>470623143</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1>CONTRYMAN ASSOCIATES PC CPA'S</BusinessNameLine1>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1>PO BOX 2246</AddressLine1>
        <City>SCOTTSBLUFF</City>
        <State>NE</State>
        <ZIPCode>69363</ZIPCode>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2013-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>363314159</EIN>
      <BusinessName>
        <BusinessNameLine1>REGIONAL WEST PHYSICIANS CLINIC</BusinessNameLine1>
      </BusinessName>
      <BusinessNameControlTxt>REGI</BusinessNameControlTxt>
      <USAddress>
        <AddressLine1>4021 AVENUE B</AddressLine1>
        <City>SCOTTSBLUFF</City>
        <State>NE</State>
        <ZIPCode>69361</ZIPCode>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>DAVID GRIFFITHS</PersonNm>
      <PersonTitleTxt>TREASURER</PersonTitleTxt>
      <SignatureDt>2014-11-15</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>DAN W CHARRON CPA CMA</PreparerPersonNm>
      <PTIN>P00036203</PTIN>
      <PhoneNum>3086357705</PhoneNum>
      <PreparationDt>2014-11-17</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2013</TaxYr>
    <BuildTS>2015-11-30 17:44:51Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCount="7">
    <IRS990 documentId="RetDoc1" referenceDocumentId="RetDoc7">
      <PrincipalOfficerNm>DAVID GRIFFITHS TREASURER</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1>4021 AVENUE B</AddressLine1>
        <City>SCOTTSBLUFF</City>
        <State>NE</State>
        <ZIPCode>69361</ZIPCode>
      </USAddress>
      <GrossReceiptsAmt>54986559</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.RWHS.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <ActivityOrMissionDesc>PROVIDE HEALTH CARE TO THE REGION INCLUDING THE UNDERSERVED.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>16</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>0</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>455</TotalEmployeeCnt>
      <TotalGrossUBIAmt>97529</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>-117</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>16206899</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>54462073</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>54622704</CYProgramServiceRevenueAmt>
      <CYInvestmentIncomeAmt>-3106</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>54018</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>179646</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>70722990</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>54799244</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>53673</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>35838</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>49930907</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>50017436</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>20925759</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>22694567</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>70910339</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>72747841</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-187349</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-17948597</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>5762282</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>5145470</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>5664658</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>6099689</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>97624</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>-954219</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>PROVIDE HEALTH CARE TO THE REGION INCLUDING THE UNDERSERVED.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>72662461</ExpenseAmt>
      <GrantAmt>35838</GrantAmt>
      <Desc>REGIONAL WEST PHYSICIANS CLINIC IS A MULTI-SPECIALTY MEDICAL GROUP OF MORE THAN 50 PHYSICIANS AND ASSOCIATED HEALTH CARE PROVIDERS. THE CLINIC IS A PHYSICIAN-LED, PHYSICIAN-GOVERNED SUBIDIARY OF REGIONAL WEST HEALTH SERVICES. IN THE TRADITION OF THE MAYO CLINIC AND OTHER SUCCESSFUL EXAMPLES OF PHYSICIAN HOSPITAL INTEGRATION, REGIONAL WEST PHYSICIANS CLINIC IS COMMITTED TO PROVIDING THE HIGHEST QUALITY PATIENT CARE AND SERVICE, PATIENT-DRIVEN HEALTH CARE GOVERNANCE AND LEADERSHIP, AND COMMUNITY OUTREACH TO THE REGION.</Desc>
      <TotalProgramServiceExpensesAmt>72662461</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc3">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc4">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc4">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc4">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc4">false</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc4">false</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc4">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc4">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc4">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc4">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc4">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc4">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc4">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc4">true</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc5">true</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc5">false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc6">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd>false</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc8">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc8">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc8">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc8">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>41</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>455</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>true</Form990TFiledInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>16</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>0</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>DAVID GRIFFITHS</PersonNm>
        <PhoneNum>3086301111</PhoneNum>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUFF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY FRIEDLEIN MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>857372</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9800</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ARMANDO MAGANA MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>851982</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JASON WALSH MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>640564</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROMMIE HUGHES MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>639982</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFFREY HOLLOWAY MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>639203</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES MASSEY MD</PersonNm>
        <TitleTxt>VP OF SURGER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>625772</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TODD SORENSEN MD</PersonNm>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>516124</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>64979</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JON MORGAN MD</PersonNm>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>16558</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>381923</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA SCHEPPERS MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>393526</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14125</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VINCENT BJORLING MD</PersonNm>
        <TitleTxt>CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>358140</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHEILA WEBB-BOWLES MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>352511</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KENT LACEY MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>267047</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8210</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID GRIFFITHS</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>255460</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38699</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SAL AZIZ</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>214772</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7667</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MILTON JOHNSON MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>141582</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5711</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID HOLDT MD</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHIRLEY GOMPERT</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>33545</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>1782</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW BRUNER</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>490535</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>4298</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DORISA POLK</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>439771</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EMILY MCCARTY</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>432440</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLINTON MERRILL</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>373561</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATE PAINTER</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>373008</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>REGINA LECONTE MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>361515</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID KANAR</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>337093</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34716</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIC WIEBE MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>310241</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MUEEN GHANI</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>298975</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8797</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERNEST BUSSINGER MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>229373</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9419</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOE JETER PAC</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>217922</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9525</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAROSLAW ANISZEWSKI</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>208875</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3077</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HECTOR SANTIAGO</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>160386</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17016</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>OMAR JIMENEZ MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>2093170</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIC GARDNER</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>685724</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27794</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MELISSA STADE MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>635038</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHAWN ACINO MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>584494</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10200</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JULIAN HENLEY</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>474650</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34496</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM MICHAEL MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>344865</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6919</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHELE ARNOLD MD</PersonNm>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>269875</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9214</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>15354067</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>1153507</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>479444</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>33</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>true</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>RURAL PARTNERS IN MEDICINE</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>PO BOX 772519</AddressLine1>
            <City>STEAMBOAT SPRINGS</City>
            <State>CO</State>
            <ZIPCode>80477</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL</ServicesDesc>
        <CompensationAmt>1295497</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>COMPHEALTH ASSOCIATES INC</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>PO BOX 972670</AddressLine1>
            <City>DALLAS</City>
            <State>TX</State>
            <ZIPCode>753972670</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL</ServicesDesc>
        <CompensationAmt>707458</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>QUALITY SYSTEMS INC</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>795 HORSHAM ROAD</AddressLine1>
            <City>HORSHAM</City>
            <State>PA</State>
            <ZIPCode>19044</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL</ServicesDesc>
        <CompensationAmt>637381</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>MEDLINK STAFFING INC</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>163 HAMPTON POINT DRIVE</AddressLine1>
            <City>ST AUGUSTINE</City>
            <State>FL</State>
            <ZIPCode>32092</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL</ServicesDesc>
        <CompensationAmt>511778</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>KEY WEST CONSULTING</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>PO BOX 32</AddressLine1>
            <City>CRAWFORD</City>
            <State>NE</State>
            <ZIPCode>69339</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL</ServicesDesc>
        <CompensationAmt>405551</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>23</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT REVENUES</Desc>
        <TotalRevenueColumnAmt>49014387</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>49014387</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONSULTING REVENUE</Desc>
        <TotalRevenueColumnAmt>5608317</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5608317</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>54622704</TotalProgramServiceRevenueAmt>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2800</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>5906</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-3106</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-3106</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-3106</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <GrossSalesOfInventoryAmt>278938</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>181409</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>97529</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>97529</UnrelatedBusinessRevenueAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS OTHER REVENUE</Desc>
        <TotalRevenueColumnAmt>82117</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>82117</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>82117</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>54799244</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>54701715</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>97529</UnrelatedBusinessRevenueAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>35838</TotalAmt>
        <ProgramServicesAmt>35838</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>10853137</TotalAmt>
        <ProgramServicesAmt>10853137</ProgramServicesAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>645608</TotalAmt>
        <ProgramServicesAmt>645608</ProgramServicesAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>31071033</TotalAmt>
        <ProgramServicesAmt>31071033</ProgramServicesAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1115127</TotalAmt>
        <ProgramServicesAmt>1115127</ProgramServicesAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>4442113</TotalAmt>
        <ProgramServicesAmt>4442113</ProgramServicesAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1890418</TotalAmt>
        <ProgramServicesAmt>1890418</ProgramServicesAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>5255</TotalAmt>
        <ProgramServicesAmt>5255</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>85380</TotalAmt>
        <ManagementAndGeneralAmt>85380</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>6406130</TotalAmt>
        <ProgramServicesAmt>6406130</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>200655</TotalAmt>
        <ProgramServicesAmt>200655</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>188082</TotalAmt>
        <ProgramServicesAmt>188082</ProgramServicesAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>45395</TotalAmt>
        <ProgramServicesAmt>45395</ProgramServicesAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>2108426</TotalAmt>
        <ProgramServicesAmt>2108426</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>300199</TotalAmt>
        <ProgramServicesAmt>300199</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>129566</TotalAmt>
        <ProgramServicesAmt>129566</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>450725</TotalAmt>
        <ProgramServicesAmt>450725</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>581178</TotalAmt>
        <ProgramServicesAmt>581178</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACY</Desc>
        <TotalAmt>7098489</TotalAmt>
        <ProgramServicesAmt>7098489</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT</Desc>
        <TotalAmt>1726098</TotalAmt>
        <ProgramServicesAmt>1726098</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>1414825</TotalAmt>
        <ProgramServicesAmt>1414825</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER PURCHASED SERVICES</Desc>
        <TotalAmt>1097285</TotalAmt>
        <ProgramServicesAmt>1097285</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>856879</TotalAmt>
        <ProgramServicesAmt>856879</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>72747841</TotalAmt>
        <ProgramServicesAmt>72662461</ProgramServicesAmt>
        <ManagementAndGeneralAmt>85380</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>329004</BOYAmt>
        <EOYAmt>307756</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>3848710</BOYAmt>
        <EOYAmt>3486201</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>215980</BOYAmt>
        <EOYAmt>227038</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>82125</BOYAmt>
        <EOYAmt>159343</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>3784538</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2894617</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1209053</BOYAmt>
        <EOYAmt>889921</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>77410</BOYAmt>
        <EOYAmt>75211</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>5762282</BOYAmt>
        <EOYAmt>5145470</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>5314658</BOYAmt>
        <EOYAmt>6099689</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>350000</BOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>5664658</BOYAmt>
        <EOYAmt>6099689</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>97624</BOYAmt>
        <EOYAmt>-954219</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>97624</BOYAmt>
        <EOYAmt>-954219</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>5762282</BOYAmt>
        <EOYAmt>5145470</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-17948597</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>16896754</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc3">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc4">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>11857</OtherCostOrOtherBasisAmt>
        <BookValueAmt>11857</BookValueAmt>
      </LandGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>104922</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>53566</DepreciationAmt>
        <BookValueAmt>51356</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3623992</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2841051</DepreciationAmt>
        <BookValueAmt>782941</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>43767</OtherCostOrOtherBasisAmt>
        <BookValueAmt>43767</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>889921</TotalBookValueLandBuildingsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc5">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>SCOTTS BLUFF COUNTY FAIR</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>10625 CO RD E</AddressLine1>
          <City>MITCHELL</City>
          <State>NE</State>
          <ZIPCode>69357</ZIPCode>
        </USAddress>
        <IRCSectionDesc>GOV</IRCSectionDesc>
        <CashGrantAmt>5881</CashGrantAmt>
      </RecipientTable>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc6">
      <HousingAllowanceOrResidenceInd>X</HousingAllowanceOrResidenceInd>
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TIMOTHY FRIEDLEIN MD</PersonNm>
        <BaseCompensationFilingOrgAmt>521196</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>335061</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1115</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9800</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22361</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>867172</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ARMANDO MAGANA MD</PersonNm>
        <BaseCompensationFilingOrgAmt>693133</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>156527</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2322</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26961</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>862182</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JASON WALSH MD</PersonNm>
        <BaseCompensationFilingOrgAmt>497441</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>141023</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2100</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25397</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>650764</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROMMIE HUGHES MD</PersonNm>
        <BaseCompensationFilingOrgAmt>496175</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>141023</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2784</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25678</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>650182</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JEFFREY HOLLOWAY MD</PersonNm>
        <BaseCompensationFilingOrgAmt>497370</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>141023</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>810</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28430</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>649403</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES MASSEY MD</PersonNm>
        <TitleTxt>VP OF SURGER</TitleTxt>
        <BaseCompensationFilingOrgAmt>621923</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>3849</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22598</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>635972</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TODD SORENSEN MD</PersonNm>
        <CompensationBasedOnRltdOrgsAmt>502745</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>13379</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>64979</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>17923</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>581103</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>61620</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JON MORGAN MD</PersonNm>
        <BaseCompensationFilingOrgAmt>16558</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>381262</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>661</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>673</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>9527</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>981</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>23421</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>17231</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>391450</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LISA SCHEPPERS MD</PersonNm>
        <BaseCompensationFilingOrgAmt>382627</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>9100</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1799</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>14125</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28218</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>407651</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>VINCENT BJORLING MD</PersonNm>
        <TitleTxt>CHAIRPERSON</TitleTxt>
        <BaseCompensationFilingOrgAmt>356509</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1631</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26818</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>368340</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHEILA WEBB-BOWLES MD</PersonNm>
        <BaseCompensationFilingOrgAmt>350686</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1825</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25288</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>362711</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KENT LACEY MD</PersonNm>
        <BaseCompensationFilingOrgAmt>207356</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>57141</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2550</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8210</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26658</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>275257</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID GRIFFITHS</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>246352</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>9108</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>38699</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>23518</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>294159</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>4881</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SAL AZIZ</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>189320</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>25452</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7667</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>13262</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>222439</TotalCompensationFilingOrgAmt>
        <CompReportPrior990FilingOrgAmt>19935</CompReportPrior990FilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW BRUNER</PersonNm>
        <BaseCompensationFilingOrgAmt>432934</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>55624</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1977</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>4298</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25877</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>494833</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DORISA POLK</PersonNm>
        <BaseCompensationFilingOrgAmt>367090</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>70743</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1938</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25317</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>449971</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EMILY MCCARTY</PersonNm>
        <BaseCompensationFilingOrgAmt>363704</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>66823</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1913</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>31316</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>442640</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CLINTON MERRILL</PersonNm>
        <BaseCompensationFilingOrgAmt>369484</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>4077</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>31875</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>383761</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATE PAINTER</PersonNm>
        <BaseCompensationFilingOrgAmt>334566</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>36533</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1909</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25902</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>383208</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>REGINA LECONTE MD</PersonNm>
        <BaseCompensationFilingOrgAmt>359953</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1562</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>13402</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>371715</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID KANAR</PersonNm>
        <BaseCompensationFilingOrgAmt>335038</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>2055</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>34716</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>861</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>371809</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERIC WIEBE MD</PersonNm>
        <BaseCompensationFilingOrgAmt>279903</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>30000</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>338</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25710</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>320441</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MUEEN GHANI</PersonNm>
        <BaseCompensationFilingOrgAmt>296984</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1991</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8797</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10609</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>307772</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERNEST BUSSINGER MD</PersonNm>
        <BaseCompensationFilingOrgAmt>226386</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>2987</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9419</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>30406</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>238792</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOE JETER PAC</PersonNm>
        <BaseCompensationFilingOrgAmt>56945</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>160941</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>36</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9525</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8896</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>227447</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAROSLAW ANISZEWSKI</PersonNm>
        <BaseCompensationFilingOrgAmt>208875</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>3077</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>21308</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>211952</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HECTOR SANTIAGO</PersonNm>
        <BaseCompensationFilingOrgAmt>160386</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>17016</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12283</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>177402</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>OMAR JIMENEZ MD</PersonNm>
        <BaseCompensationFilingOrgAmt>900726</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1190074</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2370</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25931</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>2093170</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERIC GARDNER</PersonNm>
        <BaseCompensationFilingOrgAmt>683678</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>2046</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>27794</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25931</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>713518</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MELISSA STADE MD</PersonNm>
        <BaseCompensationFilingOrgAmt>504230</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>128939</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1869</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>1008</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>645238</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHAWN ACINO MD</PersonNm>
        <BaseCompensationFilingOrgAmt>547553</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>33501</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3440</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23744</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>594694</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JULIAN HENLEY</PersonNm>
        <BaseCompensationFilingOrgAmt>469384</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>5266</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>34496</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26420</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>509146</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM MICHAEL MD</PersonNm>
        <BaseCompensationFilingOrgAmt>241028</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>101925</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1912</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>6919</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>20437</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>351784</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHELE ARNOLD MD</PersonNm>
        <BaseCompensationFilingOrgAmt>269643</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>232</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9214</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>11127</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>279089</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>TODD SORENSEN, MD 0 174,023 0 DAVID GRIFFITHS 0 26,014 0 SAL AZIZ 0 34,610 0</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc7">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM IS PRESENTED TO AND REVIEWED BY THE BOARD IN THE MONTH PRIOR TO THE FILING DEADLINE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUAL DISCLOSURE BY BOARD MEMBERS OF ANY CONFLICT OF INTEREST, AS SET FORTH IN THE POLICIES, IS REQUIRED. FOR ANY POSSIBLE CONFLICT OF INTEREST IDENTIFIED, THE REMAINING BOARD DETERMINES IF IT ACTUALLY CONSTITUTES A CONFLICT OF INTEREST WITHOUT THE CONFLICTED BOARD MEMBER PRESENT. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD, LESS THE CONFLICTED MEMBER, WILL THEN DECIDE THE LEVEL OF INVOLVEMENT OF THE MEMBER IN DECISION MAKING FOR THE ENTITY, IF THERE IS AN ALTERNATIVE ARRANGEMENT THAT WILL ELIMINATE THE CONFLICT OF INTEREST, AND THE APPROPRIATENESS OF THE CONFLICTED MEMBER CONTINUING AS A BOARD MEMBER. FAILURE TO DISCLOSE A CONFLICT OF INTEREST CAN RESULT IN DISCIPLINARY AND CORRECTIVE ACTION FOR THE CONFLICTED MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR THE COO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE RWHS BOARD. THE DETERMINATION IS BASED ON MARKET DATA AND RECOMMENDATIONS FROM AN INDEPENDENT CONSULTING FIRM WHO COLLECTS THAT INFORMATION FOR COMPARISON PURPOSES. MINUTES ARE KEPT OF THESE MEETINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR THE CEO AND KEY EMPLOYEES IS REVIEWED BY AN INDEPENDENT CONSULTANT ON AN ANNUAL BASIS TO ENSURE THE COMPENSATION PLAN MEETS REASONABLENESS TESTING COMPARED TO MGMA COMPENSATION SURVEY. THE COMPENSATION MODEL IS ALSO REVIEWED BY LEGAL COUNSEL FOR REASONABLENESS AND COMPLIANCE WITH IRS REQUIREMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS AND POLICIES ARE MADE AVAILABLE TO THE PUBLIC THROUGH BEING POSTED ON THE ORGANIZATION'S WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSFERS FROM REGIONAL WEST MEDICAL CENTER 16,900,004 TRANSFER TO REGIONAL WEST FOUNDATION 3,250</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc8">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>REGIONAL WEST HEALTH SERVICES</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUFF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
        <EIN>363314157</EIN>
        <PrimaryActivitiesTxt>HEALTH SVC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11A</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>REGIONAL WEST MEDICAL CENTER</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
        <EIN>470385129</EIN>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>PRAIRIE HAVEN HOSPICE</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
        <EIN>391904975</EIN>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>REGIONAL WEST FOUNDATION</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
        <EIN>237171022</EIN>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11B</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>PANHANDLE HEALTH PROPERTIES</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
        <EIN>363314161</EIN>
        <ExemptCodeSectionTxt>501C2</ExemptCodeSectionTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>REGIONAL WEST VILLAGE</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
        <EIN>363314162</EIN>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>9</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>REGIONAL WEST HEALTH SERVICES &amp; AFF</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
        <EIN>470658690</EIN>
        <ExemptCodeSectionTxt>501C9</ExemptCodeSectionTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1>REGIONAL CARE INC</BusinessNameLine1>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1>4021 AVENUE B</AddressLine1>
          <City>SCOTTSBLUF</City>
          <State>NE</State>
          <ZIPCode>69361</ZIPCode>
        </USAddress>
        <EIN>470760050</EIN>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1>REGIONAL WEST MEDICAL CENTER</BusinessNameLine1>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>16900004</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1>PANHANDLE HEALTH PROPERTIES</BusinessNameLine1>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>556564</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1>REGIONAL WEST HEALTH SERVICES</BusinessNameLine1>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>81180</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>