Liabilities / Assets
90th percentile
Higher debt load relative to assets than 90% of similar nonprofits.
EIN 47-0385129 • 501(c)3 • Scottsbluff, NE
Profile
PROVIDING MEDICAL CARE
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
Liabilities / Assets
90th percentile
Higher debt load relative to assets than 90% of similar nonprofits.
Liabilities / Revenue
54th percentile
Higher debt load relative to revenue than 54% of similar nonprofits.
Net Margin
39th percentile
Higher net margin than 39% of similar nonprofits.
Top Officer Pay
54th percentile
Higher top officer pay than 54% of similar nonprofits.
Top officer pay equals 0.4% of source-year revenue.
Asset Growth
83rd percentile
Faster asset growth than 83% of similar nonprofits.
Revenue Growth
57th percentile
Faster revenue growth than 57% of similar nonprofits.
Assets
Up$138,982,614
Up $19,110,370 (+16%) from 2023
Liabilities
Up$136,153,366
Up $15,638,725 (+13%) from 2023
Net Assets
Up$2,829,248
Up $3,471,645 (+540%) from 2023
Revenue
Up$255,799,668
Up $25,392,868 (+11%) from 2023
Expenses
Down$252,316,554
Down $6,421,451 (-2.5%) from 2023
Net Income
Up$3,483,114
Up $31,814,319 (+112%) from 2023
Most recent year
2024 • Form 990Facts available. Structured filing facts are available, but richer extracted sections are limited.
We are committed to advancing the health and wellness of the individuals and communities we are honored to serve.
To provide comprehensive and advanced medical care.
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Accounts Receivable | $40,681,917 | $59,824,761 | ▲ $19,142,844 |
| Land, Buildings, and Equipment, Net | $59,143,442 | $57,213,767 | ▼ $1,929,675 |
| Inventories for Sale or Use | $6,246,871 | $7,097,265 | ▲ $850,394 |
| Savings and Temporary Cash Investments | $2,107,734 | $3,813,094 | ▲ $1,705,360 |
| Prepaid Expenses and Deferred Charges | $2,902,386 | $2,221,674 | ▼ $680,712 |
| Intangible Assets | $1,007,909 | $0 | ▼ $1,007,909 |
| Investments Program Related | $561,380 | $561,380 | → $0 |
| Investments in Publicly Traded Securities | $129,638 | $126,936 | ▼ $2,702 |
| Cash and Non-Interest-Bearing Accounts | $31,665 | $31,665 | → $0 |
| Other Notes and Loans Receivable, Net | $36,500 | $24,000 | ▼ $12,500 |
| Total Assets | $119,872,244 | $138,982,614 | ▲ $19,110,370 |
| Other Assets Total | $7,022,802 | $8,068,072 | ▲ $1,045,270 |
| Liabilities | |||
| Tax Exempt Bond Liabilities | $60,959,249 | $57,637,103 | ▼ $3,322,146 |
| Accounts Payable and Accrued Expenses | $33,175,465 | $55,169,099 | ▲ $21,993,634 |
| Other Liabilities | $22,151,978 | $20,749,787 | ▼ $1,402,191 |
| Mortgage Notes Payable Secured by Investment Property | $4,198,552 | $2,567,188 | ▼ $1,631,364 |
| Deferred Revenue | $29,397 | $30,189 | ▲ $792 |
| Total Liabilities | $120,514,641 | $136,153,366 | ▲ $15,638,725 |
| Net Assets / Fund Balance | |||
| Net Assets Without Donor Restrictions | $-642,397 | $2,829,248 | ▲ $3,471,645 |
| Total Net Assets Fund Balance | $-642,397 | $2,829,248 | ▲ $3,471,645 |
| Total Liabilities and Net Assets / Fund Balance | $119,872,244 | $138,982,614 | ▲ $19,110,370 |
| Asset | Book Value | Depreciation | Basis |
|---|---|---|---|
| Buildings | $33,544,994 | $120,544,905 | $154,089,899 |
| Equipment | $11,359,396 | $118,674,197 | $130,033,593 |
| Other Land Buildings | $10,059,470 | $4,977,713 | $15,037,183 |
| Land | $2,143,930 | - | $2,143,930 |
| Leasehold Improvements | $105,977 | $65,951 | $171,928 |
| Other Assets Org | $8,058,224 | - | - |
| Period | Beginning | Contrib. | Gain/Loss | Other Uses | End |
|---|---|---|---|---|---|
| 2024 | $6,420,776 | $23,198 | ▲ $88,394 | - | $6,441,760 |
| 2023 | $5,887,872 | $544,587 | ▲ $55,824 | - | $6,420,776 |
| 2022 | $8,807,244 | $182,428 | ▼ $2,055,429 | - | $5,887,872 |
| 2021 | $7,307,997 | $190,018 | ▲ $1,350,185 | - | $8,807,244 |
| 2020 | $6,188,204 | $324,798 | ▲ $824,828 | - | $7,307,997 |
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| Gemma Tactacan | Rn | FT | $234,643 | $64,032 | $298,675 |
| Craig Noe | Pharmacist | FT | $237,643 | $44,800 | $282,443 |
| Todd Christensen | Medical Physicist | FT | $220,991 | $60,372 | $281,363 |
| Relibelle Hernandez | Rn | FT | $199,190 | $55,532 | $254,722 |
| Erika Carmody | Chief Nursing Officer | FT | $210,857 | $9,933 | $220,790 |
| Melody Bibb | Secretary | - | - | $141,005 | $141,005 |
| Alan Townsend | Interim CFO/treasurer Thru 2/2024 | - | $93,548 | - | $93,548 |
| Name | Title |
|---|---|
| Jim Trumbull | Chair |
| Mel Mcnea | CEO/president |
| Bradley Hertzler | Director |
| Carolyn Escamilla | Director |
| Dennis Hadden | Director |
| Hod Kosman | Director |
| Jeffrey Salisbury | Director |
| John Massey | Director |
| Katy Reichert | Director |
| Lee Glenn | Director |
| Matt Larsen | Director |
| Randall Williams | Director |
| Rev Lauren Ekdahl | Director |
| Seth Covalt | Director |
| Thomas Holyoke | Director |
| Troy Dean | Director |
| Michael Yung Md | Director Thru 3/2024 |
| Jeanne Mckerrigan | CFO/treasurer |
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Northstar Anesthesia Of Nebraska LLC | Anesthesia Contract | 6225 N STATE HWY 161 STE 200, Irving, TX 75038 | $6,291,938 |
| Panhandle Endovascular | Medical Services | 2001 EAST 33RD ST, Scottsbluff, NE 69361 | $1,500,000 |
| Poudre Valley Medical Group LLC | Nursing Contract | 2315 EAST HARMONY ROAD SUITE 200, Fort Collins, CO 80528 | $1,347,456 |
| Associated Regional & University Patholo | Reference Lab | PO BOX 27964, Salt Lake City, UT 84127 | $939,070 |
| Radiology Imaging Of Nebraska | Radiology Services | 10700 E GEDDES AVE SUITE 200, Englewood, CO 80112 | $699,949 |
| Line Item | Amount |
|---|---|
| Other Expenses | $161,966,091 |
| Salaries, Compensation, and Employee Benefits | $75,673,036 |
| Grants and Similar Amounts Paid | $14,677,427 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Fees for Services Other | $58,740,399 | $18,646,305 | - | $77,386,704 |
| Other Salaries and Wages | $51,593,551 | $1,741,091 | - | $53,334,642 |
| Other Employee Benefits | $15,512,834 | $1,310,861 | - | $16,823,695 |
| Grants to Domestic Orgs | $14,677,427 | - | - | $14,677,427 |
| Depreciation Depletion | $7,924,462 | $593,525 | - | $8,517,987 |
| Office Expenses | $4,288,727 | $912,578 | - | $5,201,305 |
| Occupancy | $4,762,042 | $338,999 | - | $5,101,041 |
| Payroll Taxes | $3,638,473 | $108,664 | - | $3,747,137 |
| Interest | $2,313,416 | $388,038 | - | $2,701,454 |
| Pension Plan Contributions | $1,722,221 | $45,341 | - | $1,767,562 |
| Other Expenses | $1,075,768 | $355,569 | - | $1,431,337 |
| Advertising | $62,380 | $525,627 | - | $588,007 |
| Travel | $179,921 | $111,159 | - | $291,080 |
| Fees for Service Investment Mgmnt Fees | - | $239,006 | - | $239,006 |
| All Other Expenses | - | $148,433 | - | $148,433 |
| Fees for Services Accounting | - | $109,859 | - | $109,859 |
| Fees for Services Legal | - | $22,583 | - | $22,583 |
| Insurance | $16,933 | $2,815 | - | $19,748 |
| Information Technology | $1,546 | $230 | - | $1,776 |
| Total Functional Expenses | $225,300,878 | $27,015,676 | $0 | $252,316,554 |
| Line Item | Amount |
|---|---|
| Total Expenses per Form 990 | $252,316,554 |
| Expenses per Audited Statements | $252,077,548 |
| Total Expenses per Audited Statements | $252,077,548 |
| Expenses Not Reported on Financial Statements | $239,006 |
| Expenses Not Reported on Form 990 | $0 |
| Recipient | Location | Category | Purpose | Amount |
|---|---|---|---|---|
| Regional West Physicians Clinic | Scottsbluff, NE | 501(c)(3) | To Provide Support to Affiliated Charitable Organization. | $14,659,200 |
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
| Liability | Amount |
|---|---|
| Affiliate Payable | $17,194,305 |
| Due to Third Party Payors | $1,902,566 |
| Checks Issued in Excess of Bank Balance | $952,916 |
| Ltd Malpractice Reserve | $700,000 |
| Bond | Issuer | Issued | Issue Price | Purpose |
|---|---|---|---|---|
| A | Hospital Authority No I of Scotts Bluff County Nebraska | 2016-11-30 | $84,139,686 | SEE PART VI |
| Bond | Total Proceeds | Spent | Retired | Issuance Costs |
|---|---|---|---|---|
| A | $84,139,686 | $53,110,007 | $26,045,683 | $1,025,837 |
“The executive committee, comprised of the officers of the board of directors, has authority to act on behalf of the governing body.”
“The corporation's sole member is regional west health services.”
“Regional west health services (rwhs), the sole member, has the ability to appoint 3 members of the board of directors, which is not a majority. Rwhs also has the ability to elect board members to fill any vacancy created by the failure or inability of any elected director to serve.”
“Regional west health services (rwhs), the sole member, has the power to approve or change long-term and master strategic or business plans of the organization, approve budgets, the merger, consolidation, liquidation or dissolution of the corporation, approve of or change the charity care policies and procedures, as well as the amendments to any governing documents.”
“The board will have an opportunity to review drafts electronically prior to filing.”
“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.”
“Compensation process for top official: compensation for the ceo 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. Compensation process for officers: compensation for other officers 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.”
“The organization's governing documents, conflict of interest policy and financial statements are made available to the public upon request.”
“Other purchased services: program service expenses 50,899,444. Management and general expenses 16,598,665. Fundraising expenses 0. Total expenses 67,498,109. Service contracts: program service expenses 7,840,955. Management and general expenses 2,047,640. Fundraising expenses 0. Total expenses 9,888,595.”
“The cfo of regional west health services, the sole member of the organization, is responsible for oversight of the audit and selection of the independent public accountant. This process has not changed from the prior year.”
“Restricted funds are held by regional west foundation, a related organization. These funds are restricted primarily for scholarships for nursing and health care profession students. A portion of the restricted funds are for capital improvements for rwmc.”
“The medical center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The medical center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.”
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
| Path | # | Value |
|---|---|---|
| IRS990/AccountantCompileOrReviewInd | 0 | 0 |
| IRS990/AccountsPayableAccrExpnssGrp/BOYAmt | 0 | 33175465 |
| IRS990/AccountsPayableAccrExpnssGrp/EOYAmt | 0 | 55169099 |
| IRS990/AccountsReceivableGrp/BOYAmt | 0 | 40681917 |
| IRS990/AccountsReceivableGrp/EOYAmt | 0 | 59824761 |
| IRS990/ActivitiesConductedPrtshpInd | 0 | 0 |
| IRS990/ActivityOrMissionDesc | 0 | TO PROVIDE COMPREHENSIVE AND ADVANCED MEDICAL CARE. |
| IRS990/AdvertisingGrp/ManagementAndGeneralAmt | 0 | 525627 |
| IRS990/AdvertisingGrp/ProgramServicesAmt | 0 | 62380 |
| IRS990/AdvertisingGrp/TotalAmt | 0 | 588007 |
| IRS990/AllOtherContributionsAmt | 0 | 8708 |
| IRS990/AllOtherExpensesGrp/ManagementAndGeneralAmt | 0 | 148433 |
| IRS990/AllOtherExpensesGrp/TotalAmt | 0 | 148433 |
| IRS990/AnnualDisclosureCoveredPrsnInd | 0 | 1 |
| IRS990/AuditCommitteeInd | 0 | 1 |
| IRS990/AuditedFinancialStmtAttInd | 0 | 1 |
| IRS990/BackupWthldComplianceInd | 0 | 1 |
| IRS990/BooksInCareOfDetail/PersonNm | 0 | ANDREW SHEA |
| IRS990/BooksInCareOfDetail/PhoneNum | 0 | 3086302244 |
| IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt | 0 | 4021 AVENUE B |
| IRS990/BooksInCareOfDetail/USAddress/CityNm | 0 | SCOTTSBLUFF |
| IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd | 0 | NE |
| IRS990/BooksInCareOfDetail/USAddress/ZIPCd | 0 | 693614602 |
| IRS990/BusinessRlnWith35CtrlEntInd | 0 | 0 |
| IRS990/BusinessRlnWithFamMemInd | 0 | 0 |
| IRS990/BusinessRlnWithOrgMemInd | 0 | 0 |
| IRS990/CashNonInterestBearingGrp/BOYAmt | 0 | 31665 |
| IRS990/CashNonInterestBearingGrp/EOYAmt | 0 | 31665 |
| IRS990/ChangeToOrgDocumentsInd | 0 | 0 |
| IRS990/CntrctRcvdGreaterThan100KCnt | 0 | 17 |
| IRS990/CollectionsOfArtInd | 0 | 0 |
| IRS990/CompensationFromOtherSrcsInd | 0 | 1 |
| IRS990/CompensationProcessCEOInd | 0 | 1 |
| IRS990/CompensationProcessOtherInd | 0 | 1 |
| IRS990/ConflictOfInterestPolicyInd | 0 | 1 |
| IRS990/ConservationEasementsInd | 0 | 0 |
| IRS990/ConsolidatedAuditFinclStmtInd | 0 | 1 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 0 | 6291938 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 1 | 1500000 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 2 | 1347456 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 3 | 939070 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 4 | 699949 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 0 | 6225 N STATE HWY 161 STE 200 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 1 | 2001 EAST 33RD ST |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 2 | 2315 EAST HARMONY ROAD SUITE 200 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 3 | PO BOX 27964 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 4 | 10700 E GEDDES AVE SUITE 200 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 0 | IRVING |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 1 | SCOTTSBLUFF |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 2 | FORT COLLINS |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 3 | SALT LAKE CITY |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 4 | ENGLEWOOD |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 0 | TX |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 1 | NE |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 2 | CO |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 3 | UT |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 4 | CO |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 0 | 75038 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 1 | 69361 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 2 | 80528 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 3 | 84127 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 4 | 80112 |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 0 | NORTHSTAR ANESTHESIA OF NEBRASKA LLC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 1 | PANHANDLE ENDOVASCULAR |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 2 | POUDRE VALLEY MEDICAL GROUP LLC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 3 | ASSOCIATED REGIONAL & UNIVERSITY PATHOLO |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 4 | RADIOLOGY IMAGING OF NEBRASKA |
| IRS990/ContractorCompensationGrp/ServicesDesc | 0 | ANESTHESIA CONTRACT |
| IRS990/ContractorCompensationGrp/ServicesDesc | 1 | MEDICAL SERVICES |
| IRS990/ContractorCompensationGrp/ServicesDesc | 2 | NURSING CONTRACT |
| IRS990/ContractorCompensationGrp/ServicesDesc | 3 | REFERENCE LAB |
| IRS990/ContractorCompensationGrp/ServicesDesc | 4 | RADIOLOGY SERVICES |
| IRS990/CostOfGoodsSoldAmt | 0 | 2195 |
| IRS990/CreditCounselingInd | 0 | 0 |
| IRS990/CYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/CYContributionsGrantsAmt | 0 | 2461735 |
| IRS990/CYGrantsAndSimilarPaidAmt | 0 | 14677427 |
| IRS990/CYInvestmentIncomeAmt | 0 | 122885 |
| IRS990/CYOtherExpensesAmt | 0 | 161966091 |
| IRS990/CYOtherRevenueAmt | 0 | 5675774 |
| IRS990/CYProgramServiceRevenueAmt | 0 | 247539274 |
| IRS990/CYRevenuesLessExpensesAmt | 0 | 3483114 |
| IRS990/CYSalariesCompEmpBnftPaidAmt | 0 | 75673036 |
| IRS990/CYTotalExpensesAmt | 0 | 252316554 |
| IRS990/CYTotalFundraisingExpenseAmt | 0 | 0 |
| IRS990/CYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/CYTotalRevenueAmt | 0 | 255799668 |
| IRS990/DecisionsSubjectToApprovaInd | 0 | 1 |
| IRS990/DeductibleArtContributionInd | 0 | 0 |
| IRS990/DeductibleNonCashContriInd | 0 | 0 |
| IRS990/DeferredRevenueGrp/BOYAmt | 0 | 29397 |
| IRS990/DeferredRevenueGrp/EOYAmt | 0 | 30189 |
| IRS990/DelegationOfMgmtDutiesInd | 0 | 0 |
| IRS990/DepreciationDepletionGrp/ManagementAndGeneralAmt | 0 | 593525 |
| IRS990/DepreciationDepletionGrp/ProgramServicesAmt | 0 | 7924462 |
| IRS990/DepreciationDepletionGrp/TotalAmt | 0 | 8517987 |
| IRS990/Desc | 0 | REGIONAL WEST MEDICAL CENTER (RWMC) IS A LICENSED 188-BED HOSPITAL WHICH IS A REGIONAL REFERRAL CENTER AND LEVEL II TRAUMA CENTER. THE HOSPITAL PROVIDES COMPREHENSIVE AND ADVANCED MEDICAL CARE TO PEOPLE OF WESTERN NEBRASKA AND SURROUNDING PORTIONS OF SOUTH DAKOTA, WYOMING AND COLORADO. THE PROVISION OF COMPREHENSIVE AND ADVANCED MEDICAL CARE INCLUDES SERVICES IN MANY SPECIALTIES OF MEDICINE. AREAS OF CARE INCLUDE BRAIN & SPINE, CANCER, FAMILY & CHILDREN, HEART & LUNG REHABILITATION & PAIN MANAGEMENT, SKIN AND PLASTIC SURGERY, SURGICAL CLINICS, TRAUMA & EMERGENCY, WEIGHT MANAGEMENT & WELLNESS, BEHAVIORAL HEALTH, AND END-OF-LIFE CARE. |
| IRS990/DescribedInSection501c3Ind | 0 | 1 |
| IRS990/DisregardedEntityInd | 0 | 0 |
| IRS990/DocumentRetentionPolicyInd | 0 | 1 |
| IRS990/DonorAdvisedFundInd | 0 | 0 |
| IRS990/DonorRstrOrQuasiEndowmentsInd | 0 | 1 |
| IRS990/ElectionOfBoardMembersInd | 0 | 1 |
| IRS990/EmployeeCnt | 0 | 1088 |
| IRS990/EmploymentTaxReturnsFiledInd | 0 | 1 |
| IRS990/EngagedInExcessBenefitTransInd | 0 | 0 |
| IRS990/EscrowAccountInd | 0 | 0 |
| IRS990/ExpenseAmt | 0 | 122329837 |
| IRS990/FamilyOrBusinessRlnInd | 0 | 0 |
| IRS990/FederalGrantAuditRequiredInd | 0 | 0 |
| IRS990/FeesForServicesAccountingGrp/ManagementAndGeneralAmt | 0 | 109859 |
| IRS990/FeesForServicesAccountingGrp/TotalAmt | 0 | 109859 |
| IRS990/FeesForServicesLegalGrp/ManagementAndGeneralAmt | 0 | 22583 |
| IRS990/FeesForServicesLegalGrp/TotalAmt | 0 | 22583 |
| IRS990/FeesForServicesOtherGrp/ManagementAndGeneralAmt | 0 | 18646305 |
| IRS990/FeesForServicesOtherGrp/ProgramServicesAmt | 0 | 58740399 |
| IRS990/FeesForServicesOtherGrp/TotalAmt | 0 | 77386704 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/ManagementAndGeneralAmt | 0 | 239006 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/TotalAmt | 0 | 239006 |
| IRS990/ForeignActivitiesInd | 0 | 0 |
| IRS990/ForeignFinancialAccountInd | 0 | 0 |
| IRS990/ForeignOfficeInd | 0 | 0 |
| IRS990/Form8282PropertyDisposedOfInd | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 0 | 42.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 1 | 42.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 2 | 42.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 3 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 4 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 5 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 6 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 7 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 8 | 3.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 9 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 10 | 3.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 11 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 12 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 13 | 3.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 14 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 15 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 16 | 45.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 17 | 45.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 18 | 42.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 19 | 45.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 20 | 0.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 21 | 0.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 22 | 0.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 23 | 0.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 24 | 0.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 0 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 1 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 2 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 3 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 4 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 5 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 6 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 7 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 8 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 9 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 10 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 11 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 12 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 13 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 14 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 15 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 16 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 17 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 18 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 19 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 20 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 21 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 22 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 23 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 24 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 6 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 7 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 8 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 9 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 10 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 11 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 12 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 13 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 14 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 15 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 0 | 67234 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 1 | 67087 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 2 | 63728 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 16 | 26640 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 17 | 50621 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 18 | 51942 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 19 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 20 | 61641 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 21 | 44216 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 22 | 59648 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 23 | 55191 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 24 | 9217 |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 0 | BRADLEY HERTZLER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 1 | JEFFREY SALISBURY |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 2 | TROY DEAN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 3 | JIM TRUMBULL |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 4 | SETH COVALT |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 5 | REV LAUREN EKDAHL |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 6 | CAROLYN ESCAMILLA |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 7 | LEE GLENN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 8 | DENNIS HADDEN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 9 | THOMAS HOLYOKE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 10 | HOD KOSMAN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 11 | MATT LARSEN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 12 | KATY REICHERT |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 13 | JOHN MASSEY |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 14 | RANDALL WILLIAMS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 15 | MICHAEL YUNG MD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 16 | MEL MCNEA |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 17 | JEANNE MCKERRIGAN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 18 | MELODY BIBB |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 19 | ALAN TOWNSEND |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 20 | GEMMA TACTACAN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 21 | CRAIG NOE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 22 | TODD CHRISTENSEN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 23 | RELIBELLE HERNANDEZ |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 24 | ERIKA CARMODY |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 16 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 17 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 18 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 19 | 93548 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 20 | 236643 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 21 | 237643 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 22 | 220991 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 23 | 199190 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 24 | 210857 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 0 | 850265 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 1 | 596036 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 2 | 547210 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 16 | 405730 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 17 | 230377 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 18 | 89063 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 19 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 20 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 21 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 22 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 23 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 24 | 0 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 0 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 1 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 2 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 3 | CHAIR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 5 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 6 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 7 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 8 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 9 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 10 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 11 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 12 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 13 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 14 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 15 | DIRECTOR THRU 3/2024 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 16 | CEO/PRESIDENT |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 17 | CFO/TREASURER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 18 | SECRETARY |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 19 | INTERIM CFO/TREASURER THRU 2/2024 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 20 | RN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 21 | PHARMACIST |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 22 | MEDICAL PHYSICIST |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 23 | RN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 24 | CHIEF NURSING OFFICER |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | 1 |
| IRS990/Form990TFiledInd | 0 | 1 |
| IRS990/FormationYr | 0 | 1941 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | 0 |
| IRS990/FSAuditedBasisGrp/ConsolAndSepBasisFinclStmtInd | 0 | X |
| IRS990/FSAuditedInd | 0 | 1 |
| IRS990/FundraisingActivitiesInd | 0 | 0 |
| IRS990/GainOrLossGrp/OtherAmt | 0 | 27201 |
| IRS990/GamingActivitiesInd | 0 | 0 |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 15 |
| IRS990/GovernmentGrantsAmt | 0 | 6007 |
| IRS990/GrantAmt | 0 | 14677427 |
| IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt | 0 | 14677427 |
| IRS990/GrantsToDomesticOrgsGrp/TotalAmt | 0 | 14677427 |
| IRS990/GrantsToIndividualsInd | 0 | 0 |
| IRS990/GrantsToOrganizationsInd | 0 | 1 |
| IRS990/GrantToRelatedPersonInd | 0 | 0 |
| IRS990/GrossAmountSalesAssetsGrp/OtherAmt | 0 | 27201 |
| IRS990/GrossReceiptsAmt | 0 | 255801863 |
| IRS990/GrossRentsGrp/RealAmt | 0 | 145714 |
| IRS990/GrossSalesOfInventoryAmt | 0 | 17745 |
| IRS990/GroupReturnForAffiliatesInd | 0 | 0 |
| IRS990/IncludeFIN48FootnoteInd | 0 | 1 |
| IRS990/IndependentAuditFinclStmtInd | 0 | 1 |
| IRS990/IndependentVotingMemberCnt | 0 | 12 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 109 |
| IRS990/IndoorTanningServicesInd | 0 | 0 |
| IRS990/InfoInScheduleOPartIIIInd | 0 | X |
| IRS990/InfoInScheduleOPartIXInd | 0 | X |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InfoInScheduleOPartXIIInd | 0 | X |
| IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt | 0 | 230 |
| IRS990/InformationTechnologyGrp/ProgramServicesAmt | 0 | 1546 |
| IRS990/InformationTechnologyGrp/TotalAmt | 0 | 1776 |
| IRS990/InsuranceGrp/ManagementAndGeneralAmt | 0 | 2815 |
| IRS990/InsuranceGrp/ProgramServicesAmt | 0 | 16933 |
| IRS990/InsuranceGrp/TotalAmt | 0 | 19748 |
| IRS990/IntangibleAssetsGrp/BOYAmt | 0 | 1007909 |
| IRS990/IntangibleAssetsGrp/EOYAmt | 0 | 0 |
| IRS990/InterestGrp/ManagementAndGeneralAmt | 0 | 388038 |
| IRS990/InterestGrp/ProgramServicesAmt | 0 | 2313416 |
| IRS990/InterestGrp/TotalAmt | 0 | 2701454 |
| IRS990/InventoriesForSaleOrUseGrp/BOYAmt | 0 | 6246871 |
| IRS990/InventoriesForSaleOrUseGrp/EOYAmt | 0 | 7097265 |
| IRS990/InvestmentIncomeGrp/ExclusionAmt | 0 | 95684 |
| IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt | 0 | 95684 |
| IRS990/InvestmentInJointVentureInd | 0 | 1 |
| IRS990/InvestmentsProgramRelatedGrp/BOYAmt | 0 | 561380 |
| IRS990/InvestmentsProgramRelatedGrp/EOYAmt | 0 | 561380 |
| IRS990/InvestmentsPubTradedSecGrp/BOYAmt | 0 | 129638 |
| IRS990/InvestmentsPubTradedSecGrp/EOYAmt | 0 | 126936 |
| IRS990/InvestTaxExemptBondsInd | 0 | 0 |
| IRS990/IRPDocumentCnt | 0 | 90 |
| IRS990/IRPDocumentW2GCnt | 0 | 0 |
| IRS990/LandBldgEquipAccumDeprecAmt | 0 | 244262766 |
| IRS990/LandBldgEquipBasisNetGrp/BOYAmt | 0 | 59143442 |
| IRS990/LandBldgEquipBasisNetGrp/EOYAmt | 0 | 57213767 |
| IRS990/LandBldgEquipCostOrOtherBssAmt | 0 | 301476533 |
| IRS990/LegalDomicileStateCd | 0 | NE |
| IRS990/LessCostOthBasisSalesExpnssGrp/OtherAmt | 0 | 0 |
| IRS990/LessRentalExpensesGrp/RealAmt | 0 | 0 |
| IRS990/LoanOutstandingInd | 0 | 0 |
| IRS990/LobbyingActivitiesInd | 0 | 1 |
| IRS990/LocalChaptersInd | 0 | 0 |
| IRS990/MaterialDiversionOrMisuseInd | 0 | 0 |
| IRS990/MembersOrStockholdersInd | 0 | 1 |
| IRS990/MethodOfAccountingAccrualInd | 0 | X |
| IRS990/MinutesOfCommitteesInd | 0 | 1 |
| IRS990/MinutesOfGoverningBodyInd | 0 | 1 |
| IRS990/MiscellaneousRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 3377078 |
| IRS990/MiscellaneousRevenueGrp/TotalRevenueColumnAmt | 0 | 3377078 |
| IRS990/MissionDesc | 0 | WE ARE COMMITTED TO ADVANCING THE HEALTH AND WELLNESS OF THE INDIVIDUALS AND COMMUNITIES WE ARE HONORED TO SERVE. |
| IRS990/MoreThan5000KToIndividualsInd | 0 | 0 |
| IRS990/MoreThan5000KToOrgInd | 0 | 0 |
| IRS990/MortgNotesPyblScrdInvstPropGrp/BOYAmt | 0 | 4198552 |
| IRS990/MortgNotesPyblScrdInvstPropGrp/EOYAmt | 0 | 2567188 |
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