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      </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>
        <CriticalAccessHospital>X</CriticalAccessHospital>
      </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>
        <CriticalAccessHospital>X</CriticalAccessHospital>
      </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>
        <CriticalAccessHospital>X</CriticalAccessHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Deering Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>10</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Kobuk Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>9</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Ambler Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>8</HospitalFacilityNumber>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Shungnak Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>7</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Kiana Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>6</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Buckland Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>5</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Noatak Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>4</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Kivalina Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>3</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Noorvik Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>2</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Selawik Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>false</EligibilityCriteriaExplained>
        <UsesFPGFree>false</UsesFPGFree>
        <UsesFPGDiscounted>false</UsesFPGDiscounted>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>false</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <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:Accounts receivable represents receivables for services provided at the Maniilaq Health Center. Amounts are due from Medicaid, Medicare, third-party insurance carriers, and individuals and reported net of allowance for uncollectible accounts of $2,051,330, which includes an allowance of $1,717,411.Maniilaq has amounts due from granting agencies of $2,940,968, interest receivable of $73,851 and other receivables of $12,180.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="10000105" softwareVersion="2010v3.2">
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</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>Ruth Zent</NamePerson>
        <BaseCompensationFilingOrg>212722</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>212722</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Robert Ottone</NamePerson>
        <BaseCompensationFilingOrg>159316</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>159316</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Nathan Kotch</NamePerson>
        <BaseCompensationFilingOrg>167944</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>167944</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Lucy Nelson</NamePerson>
        <BaseCompensationFilingOrg>168361</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>168361</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ian Erlich</NamePerson>
        <BaseCompensationFilingOrg>280330</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>280330</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Faith Frable</NamePerson>
        <BaseCompensationFilingOrg>209134</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>209134</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Erick Torres-Semprit</NamePerson>
        <BaseCompensationFilingOrg>203891</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>203891</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ellen Elmore</NamePerson>
        <BaseCompensationFilingOrg>232869</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>232869</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ella Derbyshire</NamePerson>
        <BaseCompensationFilingOrg>230397</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>230397</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="10000105" softwareVersion="2010v3.2">
      <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 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 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: 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="10000105" softwareVersion="2010v3.2">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Maniilaq Services LLC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1700 Seventh Ave Ste 2100</AddressLine1>
          <City>Seattle</City>
          <State>WA</State>
          <ZIPCode>98101</ZIPCode>
        </AddressUS>
        <EIN>770671852</EIN>
        <PrimaryActivities>Maintenance Services</PrimaryActivities>
        <LegalDomicileState>WA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <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>l</TransactionType>
        <AmountInvolved>555546</AmountInvolved>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>