<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2022v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-05-15T18:02:56-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>911194016</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CLARK NUBER PS</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>10900 NE 4TH STREET SUITE 1400</AddressLine1Txt>
        <CityNm>BELLEVUE</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98004</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>916057438</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>NORTHWEST KIDNEY CENTERS</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>NORT</BusinessNameControlTxt>
      <PhoneNum>2062922771</PhoneNum>
      <USAddress>
        <AddressLine1Txt>12901 20TH AVENUE S</AddressLine1Txt>
        <CityNm>SEATAC</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98168</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>JENNIFER ESLAVA</PersonNm>
      <PersonTitleTxt>VP OF FINANCE &amp; CFO</PersonTitleTxt>
      <PhoneNum>2062922771</PhoneNum>
      <SignatureDt>2024-05-15</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>JENNIFER</PersonFirstNm>
        <PersonLastNm>ESLAVA</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>SARA ELIZABETH H JONES</PreparerPersonNm>
      <PTIN>P00235495</PTIN>
      <PhoneNum>4254544919</PhoneNum>
      <PreparationDt>2024-05-15</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="12">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>REBECCA FOX</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>12901 20TH AVENUE S</AddressLine1Txt>
        <CityNm>SEATAC</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98168</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>151670211</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.NWKIDNEY.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1962</FormationYr>
      <LegalDomicileStateCd>WA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROMOTE THE OPTIMAL HEALTH, QUALITY OF LIFE AND INDEPENDENCE OF PEOPLE WITH KIDNEY DISEASE THROUGH PATIENT CARE, EDUCATION AND RESEARCH.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>10</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>1021</TotalEmployeeCnt>
      <TotalVolunteersCnt>520</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>5190539</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1953543</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>123384429</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>129378506</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>35064249</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>3368502</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>-1069284</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>-1717256</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>162569933</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>132983295</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>2780496</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>615673</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>68724202</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>73418319</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>950608</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>55498704</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>61878616</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>127003402</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>135912608</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>35566531</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-2929313</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>259504016</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>290233438</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>89974634</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>121973180</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>169529382</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>168260258</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>NORTHWEST KIDNEY CENTERS (NKC) IS A NOT-FOR-PROFIT, LOCALLY MANAGED PROVIDER OF KIDNEY DIALYSIS, PUBLIC HEALTH EDUCATION AND RESEARCH INTO THE CAUSES AND TREATMENTS OF CHRONIC KIDNEY DISEASE. FOUNDED IN SEATTLE IN 1962, NKC WAS THE WORLD'S FIRST OUTPATIENT DIALYSIS ORGANIZATION. AMONG THE EIGHT LARGEST DIALYSIS PROVIDERS IN THE COUNTRY, NKC IS AN INFLUENTIAL MODEL BECAUSE OF ITS HIGH QUALITY SERVICES, DEEP COMMUNITY CONNECTIONS AND GENEROUS DONOR SUPPORT.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>112969616</ExpenseAmt>
      <RevenueAmt>127829953</RevenueAmt>
      <Desc>IN THE YEAR ENDED JUNE 30, 2023, NORTHWEST KIDNEY CENTERS (NKC) PROVIDED 290,032 DIALYSIS TREATMENTS, ESSENTIAL TO SUSTAIN THE LIVES OF PEOPLE WITH KIDNEY FAILURE. NKC SERVED A TOTAL OF 2,735 PATIENTS. THE ORGANIZATION PROVIDED PATIENT CARE IN TWENTY (20) FREE STANDING CLINICS AND IN EIGHT (8) LOCAL HOSPITALS, AND SUPERVISED SELF-DIALYSIS TREATMENTS IN THE HOMES OF PATIENTS THROUGHOUT THE COMMUNITY. NKC SPENT OVER $29 MILLION MORE ON THE CARE OF PATIENTS WITH MEDICARE AND MEDICAID INSURANCE THAN THE PROGRAMS REIMBURSED. IN ADDITION, NKC PROVIDED MORE THAN $2.0 MILLION IN CHARITY CARE. NORTHWEST KIDNEY CENTERS' RENAL SPECIALTY PHARMACY, A RARITY IN THE NATION, SERVED MORE THAN 1,961 DIALYSIS PATIENTS AND KIDNEY TRANSPLANT RECIPIENTS DURING THE YEAR. THE CENTER FOR DIALYSIS INNOVATION WAS ESTABLISHED BY THE UNIVERSITY OF WASHINGTON WITH A GRANT FROM NORTHWEST KIDNEY CENTERS FOR $15 MILLION OVER FIVE YEARS. THE MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF PEOPLE WITH ADVANCED KIDNEY DISEASE WHO ARE INITIATING AND RECEIVING DIALYSIS TREATMENT.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>901826</ExpenseAmt>
        <Desc>NORTHWEST KIDNEY CENTERS (NKC) OFFERS FREE CLASSES THAT HELP PEOPLE WITH CHRONIC KIDNEY DISEASE PRESERVE KIDNEY FUNCTION, CHOOSE APPROPRIATE TREATMENT, TAKE CARE OF A TRANSPLANTED KIDNEY AND IN GENERAL BE AN EMPOWERED PARTNER IN THEIR KIDNEY HEALTH CARE. THE CLASS PROGRAM PROVIDES OUTREACH TO PEOPLE WHO ARE NOT DIALYSIS PATIENTS AND MAY HELP THEM KEEP THEIR KIDNEYS HEALTHY ENOUGH SO THAT THEY NEVER NEED TO GO ON DIALYSIS, OR CAN DELAY ITS ONSET. THE PATIENT-FOCUSED, EVIDENCE-BASED CURRICULUM WAS DEVELOPED BY NORTHWEST KIDNEY CENTERS. THERE WERE 716 CHRONIC KIDNEY DISEASE EDUCATION PARTICIPANTS DURING THE YEAR.IN ADDITION TO ITS FREE CLASSES, NORTHWEST KIDNEY CENTERS PARTICIPATED IN OR PRODUCED 55 TOTAL OUTREACH ACTIVITIES, INCLUDING 20 SPEAKING ENGAGEMENTS AND 35 COMMUNITY EVENTS, ENABLING NKC TO REACH A COMBINED TOTAL OF 6,580 PEOPLE THROUGHOUT THE YEAR. THIS WAS DONE WITH THE GENEROUS SUPPORT OF 520 VOLUNTEERS WHO CONTRIBUTED 4,030 HOURS OF THEIR TIME TO HELPING OUR NONPROFIT ORGANIZATION IN MULTIPLE WAYS DURING THE CORONAVIRUS PANDEMIC.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>597937</ExpenseAmt>
        <GrantAmt>597937</GrantAmt>
        <Desc>NORTHWEST KIDNEY CENTERS (NKC) PROVIDED NEPHROLOGY FELLOWSHIPS FOR THREE (3) PHYSICIANS TO DO ADVANCED STUDY OF KIDNEY DISEASE AND RENAL CARE AT THE UNIVERSITY OF WASHINGTON. NKC AIMS TO ENSURE THAT PROFESSIONAL CARE WILL CONTINUE TO BE AVAILABLE FOR FUTURE KIDNEY PATIENTS. WE PROVIDED SIGNIFICANT SUPPORT FOR THE KIDNEY RESEARCH INSTITUTE, A COLLABORATION BETWEEN NORTHWEST KIDNEY CENTERS AND UW MEDICINE. THE KIDNEY RESEARCH INSTITUTE HAS HAD HUNDREDS OF STUDIES UNDERWAY, FOCUSING ON THE ROLE OF GENETICS, IMPACT OF LIFESTYLE, AND DIABETES IN KIDNEY DISEASE, AS WELL AS WAYS TO IMPROVE DIALYSIS OUTCOMES. THE KIDNEY RESEARCH INSTITUTE PUBLISHED THOUSANDS OF SCIENTIFIC PAPERS IN PEER-REVIEWED JOURNALS FROM ITS INCEPTION IN 2008. NORTHWEST KIDNEY CENTERS' INVESTMENT IN THE KIDNEY RESEARCH INSTITUTE HAS HELPED TO LEVERAGE HUNDREDS OF MILLIONS IN FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>17736</ExpenseAmt>
        <GrantAmt>17736</GrantAmt>
        <Desc>EMERGENCY ASSISTANCE PROGRAMS: NORTHWEST KIDNEY CENTERS PROVIDED FINANCIAL ASSISTANCE TO NEEDY PATIENTS WITH FOOD, HOUSING, AND OTHER EXPENSES (76 PATIENTS).</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>17736</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>17736</TotalOtherProgSrvcGrantAmt>
      <TotalProgramServiceExpensesAmt>114487115</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039700001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>1</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentId="RetDoc1041300001">0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="RetDoc1041300001">1</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentId="RetDoc1041300001">1</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">1</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="RetDoc1053100001">1</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>0</InvestTaxExemptBondsInd>
      <EscrowAccountInd>0</EscrowAccountInd>
      <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="RetDoc1042900001">1</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="RetDoc1042900001">0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043500001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043500001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043500001">0</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043500001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043500001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>60</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>1021</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>1</QuidProQuoContributionsInd>
      <QuidProQuoContriDisclInd>1</QuidProQuoContriDisclInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>10</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>1</InvestmentInJointVentureInd>
      <WrittenPolicyOrProcedureInd>0</WrittenPolicyOrProcedureInd>
      <StatesWhereCopyOfReturnIsFldCd>WA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>JENNIFER ESLAVA</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>2062922771</PhoneNum>
        <USAddress>
          <AddressLine1Txt>12901 20TH AVENUE S</AddressLine1Txt>
          <CityNm>SEATAC</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>98168</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>REBECCA FOX</PersonNm>
        <TitleTxt>CEO &amp; PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>614931</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30659</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RAJ MEHROTRA</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD GREAVES</PersonNm>
        <TitleTxt>BOARD MEMBER, CHAIR FROM 06/23</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRIS SEEL</PersonNm>
        <TitleTxt>VICE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DOUG ROSS</PersonNm>
        <TitleTxt>BOARD MEMBER, VICE CHAIR FROM 06/23</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENN BRENNER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MEREDITH MATHEWS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD BLOCH</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>REX OCHI</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK OSTROW</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RUSS STEPP</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>QUITA HIGHSMITH</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUZANNE WATNICK</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>453690</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20095</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELIZABETH MCNAMARA</PersonNm>
        <TitleTxt>CHIEF ADMINISTRATIVE OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>329860</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12112</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBIN LARMER</PersonNm>
        <TitleTxt>VP LEGAL AFFAIRS, CCO, &amp; SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>189617</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7882</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JULIE LYNN PETERSON</PersonNm>
        <TitleTxt>VP OF FINANCE &amp; CFO THRU 12/22</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>127721</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JANE SINFUEGO</PersonNm>
        <TitleTxt>REGISTERED NEPHROLOGY NURSE</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>245521</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18028</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TODD BUI</PersonNm>
        <TitleTxt>REGISTERED NEPHROLOGY NURSE</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>245024</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15248</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TANYA WOLFF</PersonNm>
        <TitleTxt>REGISTERED NEPHROLOGY NURSE</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>220722</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15295</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS MONTEMAYOR</PersonNm>
        <TitleTxt>PHARMACY MANAGER</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>209822</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15605</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL TRIOMPO</PersonNm>
        <TitleTxt>PROJECT MANAGER</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>207080</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16785</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TONIA CAMPBELL</PersonNm>
        <TitleTxt>FORMER CFO &amp; TREASURER THRU 6/22</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>198967</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11333</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3042955</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>163042</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>156</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ASCEND CLINICAL LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 45021</AddressLine1Txt>
            <CityNm>SAN FRANCISCO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>941450021</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LABORATORY SERVICES</ServicesDesc>
        <CompensationAmt>1542960</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>POLYCLINIC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 22608</AddressLine1Txt>
            <CityNm>SEATTLE</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98122</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CLINICAL SERVICES</ServicesDesc>
        <CompensationAmt>328410</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HEALTHCARE SUPPORT STAFFING LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>101 SOUTHHALL LANE</AddressLine1Txt>
            <CityNm>MAITLAND</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>32751</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>STAFFING SERVICES</ServicesDesc>
        <CompensationAmt>304268</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CLARK NUBER PS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>10900 NE 4TH ST SUITE 1400</AddressLine1Txt>
            <CityNm>BELLEVUE</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>980045841</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>AUDIT AND TAX</ServicesDesc>
        <CompensationAmt>192590</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NEW CHAPTER WEDDINGS &amp; EVENTS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>18404 36TH AVENUE W C</AddressLine1Txt>
            <CityNm>LYNWWOD</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98037</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EVENT PLANNING AND COORDINATION</ServicesDesc>
        <CompensationAmt>168567</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>889692</FundraisingAmt>
      <AllOtherContributionsAmt>1063851</AllOtherContributionsAmt>
      <NoncashContributionsAmt>159162</NoncashContributionsAmt>
      <TotalContributionsAmt>1953543</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>DIALYSIS</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>120217976</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>120217976</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT LAB REVENUE</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>8905045</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8905045</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER MEDICAL RELATED</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>232476</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>232476</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>INSUR PREMIUM REIMBURS</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>23009</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>23009</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>129378506</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2802412</TotalRevenueColumnAmt>
        <ExclusionAmt>2802412</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>110141</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>27074</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>83067</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>83067</TotalRevenueColumnAmt>
        <ExclusionAmt>83067</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>13835968</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>12817323</SecuritiesAmt>
        <OtherAmt>452555</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1018645</SecuritiesAmt>
        <OtherAmt>-452555</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>566090</TotalRevenueColumnAmt>
        <ExclusionAmt>566090</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>124422</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>889692</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>436881</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-312459</TotalRevenueColumnAmt>
        <ExclusionAmt>-312459</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>35200</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>35200</TotalRevenueColumnAmt>
        <ExclusionAmt>35200</ExclusionAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>3391171</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>4953083</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-1561912</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-1561912</RelatedOrExemptFuncIncomeAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>REIMBURSEMENTS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>25285</TotalRevenueColumnAmt>
        <ExclusionAmt>25285</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MED RECORDS/COUNSELING</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>13359</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13359</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>204</TotalRevenueColumnAmt>
        <ExclusionAmt>204</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>38848</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>132983295</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>127829953</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>3199799</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>597937</TotalAmt>
        <ProgramServicesAmt>597937</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>17736</TotalAmt>
        <ProgramServicesAmt>17736</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2133228</TotalAmt>
        <ProgramServicesAmt>80525</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2052703</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>57445241</TotalAmt>
        <ProgramServicesAmt>49151443</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7714626</ManagementAndGeneralAmt>
        <FundraisingAmt>579172</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>2084183</TotalAmt>
        <ProgramServicesAmt>1790692</ProgramServicesAmt>
        <ManagementAndGeneralAmt>277246</ManagementAndGeneralAmt>
        <FundraisingAmt>16245</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>6818603</TotalAmt>
        <ProgramServicesAmt>5856477</ProgramServicesAmt>
        <ManagementAndGeneralAmt>910498</ManagementAndGeneralAmt>
        <FundraisingAmt>51628</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>4937064</TotalAmt>
        <ProgramServicesAmt>4134820</ProgramServicesAmt>
        <ManagementAndGeneralAmt>755489</ManagementAndGeneralAmt>
        <FundraisingAmt>46755</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>1895325</TotalAmt>
        <ProgramServicesAmt>1803625</ProgramServicesAmt>
        <ManagementAndGeneralAmt>91700</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>270757</TotalAmt>
        <ProgramServicesAmt>4640</ProgramServicesAmt>
        <ManagementAndGeneralAmt>266117</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>191337</TotalAmt>
        <ManagementAndGeneralAmt>191337</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>53554</TotalAmt>
        <ManagementAndGeneralAmt>53554</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>198810</TotalAmt>
        <ManagementAndGeneralAmt>198810</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>7307053</TotalAmt>
        <ProgramServicesAmt>2938662</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4368391</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>286054</TotalAmt>
        <ProgramServicesAmt>6347</ProgramServicesAmt>
        <ManagementAndGeneralAmt>244046</ManagementAndGeneralAmt>
        <FundraisingAmt>35661</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>2302952</TotalAmt>
        <ProgramServicesAmt>2003547</ProgramServicesAmt>
        <ManagementAndGeneralAmt>206097</ManagementAndGeneralAmt>
        <FundraisingAmt>93308</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>3823388</TotalAmt>
        <ProgramServicesAmt>3228464</ProgramServicesAmt>
        <ManagementAndGeneralAmt>567183</ManagementAndGeneralAmt>
        <FundraisingAmt>27741</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>9892022</TotalAmt>
        <ProgramServicesAmt>9638620</ProgramServicesAmt>
        <ManagementAndGeneralAmt>249135</ManagementAndGeneralAmt>
        <FundraisingAmt>4267</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>308688</TotalAmt>
        <ProgramServicesAmt>121695</ProgramServicesAmt>
        <ManagementAndGeneralAmt>175565</ManagementAndGeneralAmt>
        <FundraisingAmt>11428</FundraisingAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>44795</TotalAmt>
        <ProgramServicesAmt>28380</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15826</ManagementAndGeneralAmt>
        <FundraisingAmt>589</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>1182909</TotalAmt>
        <ProgramServicesAmt>956738</ProgramServicesAmt>
        <ManagementAndGeneralAmt>226171</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>7324779</TotalAmt>
        <ProgramServicesAmt>7114312</ProgramServicesAmt>
        <ManagementAndGeneralAmt>203387</ManagementAndGeneralAmt>
        <FundraisingAmt>7080</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>541204</TotalAmt>
        <ProgramServicesAmt>233433</ProgramServicesAmt>
        <ManagementAndGeneralAmt>307538</ManagementAndGeneralAmt>
        <FundraisingAmt>233</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>21039327</TotalAmt>
        <ProgramServicesAmt>20759932</ProgramServicesAmt>
        <ManagementAndGeneralAmt>248220</ManagementAndGeneralAmt>
        <FundraisingAmt>31175</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LAB TESTING</Desc>
        <TotalAmt>1472531</TotalAmt>
        <ProgramServicesAmt>1426970</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45561</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>693002</TotalAmt>
        <ProgramServicesAmt>582054</ProgramServicesAmt>
        <ManagementAndGeneralAmt>109900</ManagementAndGeneralAmt>
        <FundraisingAmt>1048</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>664407</TotalAmt>
        <ProgramServicesAmt>664407</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>2385722</TotalAmt>
        <ProgramServicesAmt>1345659</ProgramServicesAmt>
        <ManagementAndGeneralAmt>995785</ManagementAndGeneralAmt>
        <FundraisingAmt>44278</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>135912608</TotalAmt>
        <ProgramServicesAmt>114487115</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20474885</ManagementAndGeneralAmt>
        <FundraisingAmt>950608</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>7472854</BOYAmt>
        <EOYAmt>5165418</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>838107</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>1637135</BOYAmt>
        <EOYAmt>122729</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>22671263</BOYAmt>
        <EOYAmt>30578880</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1688186</BOYAmt>
        <EOYAmt>1661434</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1233968</BOYAmt>
        <EOYAmt>1393594</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>227257832</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>91217086</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>121394249</BOYAmt>
        <EOYAmt>136040746</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>101531402</BOYAmt>
        <EOYAmt>91679495</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>959562</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1874959</BOYAmt>
        <EOYAmt>21793473</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>259504016</BOYAmt>
        <EOYAmt>290233438</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>13776006</BOYAmt>
        <EOYAmt>17146269</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>1760414</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>175186</BOYAmt>
        <EOYAmt>242963</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>69461254</BOYAmt>
        <EOYAmt>80390501</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>4801774</BOYAmt>
        <EOYAmt>24193447</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>89974634</BOYAmt>
        <EOYAmt>121973180</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>160909187</BOYAmt>
        <EOYAmt>162910639</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>8620195</BOYAmt>
        <EOYAmt>5349619</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>169529382</BOYAmt>
        <EOYAmt>168260258</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>259504016</BOYAmt>
        <EOYAmt>290233438</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-2929313</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>1856502</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-196313</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>3120286</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>6649783</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4755799</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5190539</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1953543</CurrentTaxYearAmt>
        <TotalAmt>21669950</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>129373010</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>125457680</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>126078883</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>127518165</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>132783036</CurrentTaxYearAmt>
        <TotalAmt>641210774</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>132493296</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>132107463</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>130834682</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>132708704</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>134736579</CurrentTaxYearAmt>
        <TotalAmt>662880724</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>94013</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>82922</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>29387</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>47050</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>77908</CurrentTaxYearAmt>
        <TotalAmt>331280</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>94013</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>82922</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>29387</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>47050</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>77908</CurrentTaxYearAmt>
        <TotalAmt>331280</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>662549444</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>1834547</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1507117</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1220626</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1389334</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2912553</CurrentTaxYearAmt>
        <TotalAmt>8864177</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>1834547</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1507117</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1220626</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1389334</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2912553</CurrentTaxYearAmt>
        <TotalAmt>8864177</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>34504</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>18147</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>13412</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>58330</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>25489</CurrentTaxYearAmt>
        <TotalAmt>149882</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>134362347</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>133632727</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>132068720</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>134156368</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>137674621</CurrentTaxYearAmt>
        <TotalAmt>671894783</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98610</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98730</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01320</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01180</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MISC INCOME - 2018 AMOUNT: $ 7,351. 2019 AMOUNT: $ 1,364. 2020 AMOUNT: $ 308. 2021 AMOUNT: $ 124. 2022 AMOUNT: $ 204. REIMBURSEMENTS - 2018 AMOUNT: $ 27,153. 2019 AMOUNT: $ 16,783. 2020 AMOUNT: $ 10,992. 2021 AMOUNT: $ 58,206. 2022 AMOUNT: $ 25,285. CONSIGNMENT SALES - 2020 AMOUNT: $ 2,112.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <VolunteersInd>1</VolunteersInd>
      <PaidStaffOrManagementInd>1</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>1</GrantsOtherOrganizationsInd>
      <GrantsOtherOrganizationsAmt>52500</GrantsOtherOrganizationsAmt>
      <DirectContactLegislatorsInd>1</DirectContactLegislatorsInd>
      <DirectContactLegislatorsAmt>1054</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>0</OtherActivitiesInd>
      <TotalLobbyingExpendituresAmt>53554</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>NORTHWEST KIDNEY CENTERS ENGAGED IN LOBBYING AT THE STATE AND FEDERAL LEVEL DURING THE FISCAL YEAR ENDED 6/30/23. GRANTS TO ORGANIZATIONS FOR LOBBYING PURPOSES INCLUDE PAYMENTS TO KIDNEY RELATED LOBBYING ORGANIZATIONS. NORTHWEST KIDNEY CENTERS ACTIVELY WORKS WITH INDUSTRY ORGANIZATIONS SUCH AS NKCA (NON-PROFIT KIDNEY CARE ALLIANCE) AND KCC (KIDNEY CARE COUNCIL) TO WORK WITH POLICY MAKERS AND INDUSTRY REPRESENTATIVES TO GUIDE POLICY AT THE NATIONAL AND STATE LEVELS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>7076690</BeginningYearBalanceAmt>
        <ContributionsAmt>18377</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>408191</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>287680</OtherExpendituresAmt>
        <EndYearBalanceAmt>7215578</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>8359321</BeginningYearBalanceAmt>
        <ContributionsAmt>17146</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-1021170</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>278607</OtherExpendituresAmt>
        <EndYearBalanceAmt>7076690</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>7089980</BeginningYearBalanceAmt>
        <ContributionsAmt>17221</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>1520344</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>268224</OtherExpendituresAmt>
        <EndYearBalanceAmt>8359321</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>6760332</BeginningYearBalanceAmt>
        <ContributionsAmt>266203</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>251217</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>187772</OtherExpendituresAmt>
        <EndYearBalanceAmt>7089980</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>6484754</BeginningYearBalanceAmt>
        <ContributionsAmt>272206</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>282189</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>278817</OtherExpendituresAmt>
        <EndYearBalanceAmt>6760332</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.53640</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.37210</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.09150</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>20271275</OtherCostOrOtherBasisAmt>
        <BookValueAmt>20271275</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>87539839</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>15551177</DepreciationAmt>
        <BookValueAmt>71988662</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>52352967</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>36282268</DepreciationAmt>
        <BookValueAmt>16070699</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>51542311</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>39383641</DepreciationAmt>
        <BookValueAmt>12158670</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>15551440</OtherCostOrOtherBasisAmt>
        <BookValueAmt>15551440</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>136040746</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>SECURITY DEPOSITS</Desc>
        <BookValueAmt>128370</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>DEFERRED COMPENSATION</Desc>
        <BookValueAmt>155469</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>BENEFICIAL INTEREST IN SPLIT INTEREST AGREEMENTS</Desc>
        <BookValueAmt>1352286</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT OF USE ASSETS</Desc>
        <BookValueAmt>20157348</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>21793473</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED COMPENSATION</Desc>
        <Amt>155469</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED RENT</Desc>
        <Amt>1499865</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITY</Desc>
        <Amt>22538113</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>24193447</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>139326575</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>1856502</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>-731450</OtherRevenueAmt>
      <RevenueNotReportedAmt>1125052</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>138201523</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>198810</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>-5417038</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-5218228</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>132983295</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>140466429</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>5417038</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>5417038</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>135049391</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>198810</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>664407</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>863217</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>135912608</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART V, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>ENDOWMENT FUNDS ARE USED FOR A WIDE VARIETY OF PATIENT SUPPORT NEEDS AND KIDNEY RESEARCH, INCLUDING CHRONIC KIDNEY DISEASE PATIENT EDUCATION, TRANSPORTATION SUPPORT TO TREATMENT APPOINTMENTS, TRAINING FOR PATIENTS TO PERFORM DIALYSIS TREATMENTS FROM THEIR HOME, AND ACCESS TO CLINICAL TRIALS THROUGH OUR PARTNERSHIP WITH THE KIDNEY RESEARCH INSTITUTE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -59,312. BAD DEBT EXPENSE REPORTED ON PART IX -664,407. PRIOR YEAR PLEDGE WRITEOFFS -7,731.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES REPORTED ON PART VIII -27,074. SPECIAL EVENT EXPENSES REPORTED ON PART VIII -436,881. PHARMACY COST OF GOODS SOLD REPORTED ON PART VIII -4,953,083.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES REPORTED ON PART VIII 27,074. SPECIAL EVENT EXPENSES REPORTED ON PART VIII 436,881. PHARMACY COST OF GOODS SOLD REPORTED ON PART VIII 4,953,083.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE REPORTED ON PART IX 664,407.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041300001">
      <FundraisingEventInformationGrp>
        <Event1Nm>GALA</Event1Nm>
        <GrossReceiptsEvent1Amt>1014114</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>889692</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>124422</GrossRevenueEvent1Amt>
        <RentFacilityCostsEvent1Amt>30366</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>160246</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>1300</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>244969</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>1014114</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>889692</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>124422</GrossRevenueTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>30366</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>160246</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>1300</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>244969</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>436881</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-312459</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
      <GamingInformationGrp>
        <GrossRevenueOtherGamingAmt>35200</GrossRevenueOtherGamingAmt>
        <VolunteerLaborOtherGamingInd>1</VolunteerLaborOtherGamingInd>
        <VolunteerLaborOtherGamingPct>1.00000</VolunteerLaborOtherGamingPct>
        <GrossRevenueTotalGamingAmt>35200</GrossRevenueTotalGamingAmt>
        <NetGamingIncomeSummaryAmt>35200</NetGamingIncomeSummaryAmt>
      </GamingInformationGrp>
      <StatesWhereGamingConductedCd>WA</StatesWhereGamingConductedCd>
      <LicensedInd>1</LicensedInd>
      <LicenseSuspendedEtcInd>0</LicenseSuspendedEtcInd>
      <GamingWithNonmembersInd>0</GamingWithNonmembersInd>
      <MemberOfOtherEntityInd>0</MemberOfOtherEntityInd>
      <GamingOwnFacilityPct>1.00000</GamingOwnFacilityPct>
      <GamingOtherFacilityPct>0.00000</GamingOtherFacilityPct>
      <IndividualWithBooksNm>JACQUI WEBER</IndividualWithBooksNm>
      <PersonsWithBooksUSAddress>
        <AddressLine1Txt>12901 20TH AVENUE S</AddressLine1Txt>
        <CityNm>SEATAC</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98168</ZIPCd>
      </PersonsWithBooksUSAddress>
      <CntrctWith3rdPrtyForGameRevInd>0</CntrctWith3rdPrtyForGameRevInd>
      <GamingManagerPersonNm>JACQUI WEBER</GamingManagerPersonNm>
      <GamingManagerCompensationAmt>0</GamingManagerCompensationAmt>
      <GamingManagerServicesProvTxt>MAINTAINED ALL RECORDS OF RAFFLE HELD FOR THE ANNUAL GALA</GamingManagerServicesProvTxt>
      <GamingManagerIsEmployeeInd>X</GamingManagerIsEmployeeInd>
      <CharitableDistributionRqrInd>0</CharitableDistributionRqrInd>
    </IRS990ScheduleG>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNIVERSITY OF WASHINGTON</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3917 UNIVERSITY WAY NE</AddressLine1Txt>
          <CityNm>SEATTLE</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>98105</ZIPCd>
        </USAddress>
        <RecipientEIN>916001537</RecipientEIN>
        <IRCSectionDesc>GOVERNMENT</IRCSectionDesc>
        <CashGrantAmt>597937</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>SEE SCHEDULE I, PART IV.</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>INDIVIDUAL GRANTS</GrantTypeTxt>
        <RecipientCnt>76</RecipientCnt>
        <CashGrantAmt>13736</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>SCHOLARSHIPS</GrantTypeTxt>
        <RecipientCnt>4</RecipientCnt>
        <CashGrantAmt>4000</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>GIFT TO THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (UWSOM)/DIVISION OF NEPHROLOGY: AS DESCRIBED IN THE "GIFT AGREEMENT BETWEEN NORTHWEST KIDNEY CENTERS AND UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE/DIVISION OF NEPHROLOGY" (DATED AUGUST 21, 2006) ALONG WITH ITS FOLLOWING 15 ANNUAL EXTENSIONS; THE FOLLOWING PROVISIONS WERE ESTABLISHED IN REGARD TO PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: NKC WILL PROVIDE GIFTS DIRECTED TO THE UW DIVISION OF NEPHROLOGY TO A) ENHANCE THE TRAINING OF FELLOWS IN NEPHROLOGY, AND B) TO SUPPORT BASIC RESEARCH INTO THE CAUSES AND CURES OF KIDNEY DISEASE, AND TO SUPPORT THE ACTIVITIES OF THE KIDNEY RESEARCH INSTITUTE AT THE UNIVERSITY OF WASHINGTON. NKC AND UWSOM AGREE THAT THESE GIFTS WILL NOT BE USED TO PAY UWSOM OVERHEAD, DEPARTMENT ASSESSMENTS, OR INDIRECT COSTS ON STUDIES. THE PARTIES FURTHER AGREE THAT THE UWSOM IS RESPONSIBLE FOR STEWARDSHIP OF THESE FUNDS AND WILL DIRECTLY UTILIZE THE FULL AMOUNT OF THE GIFTS. THERE ARE NO CONTRACTUAL ARRANGEMENTS ASSOCIATED WITH THE FUNDS, WHICH REQUIRE OR PROVIDE FOR COMPLIANCES WITH PROTOCOLS, PATIENT RIGHTS, TECHNOLOGY TRANSFER OR OTHER SIMILAR CONDITIONS OR PROPRIETARY INFORMATION WITH NKC. PARAGRAPH D-PERIODICALLY UWSOM WILL PROVIDE NKC WRITTEN AND VERBAL REPORTS AND INFORMATIONAL PRESENTATIONS REGARDING THE ACTIVITIES OF THE FUNDED FELLOWS, THE BASIC RESEARCH CONDUCTED WITH NKC FUNDING, AND ACTIVITIES OF THE KIDNEY RESEARCH INSTITUTE, AT A SCHEDULE MUTUALLY AGREED UPON BETWEEN THE NKC PRESIDENT AND CEO AND THE UW HEAD, DIVISION OF NEPHROLOGY. UPON REQUEST UWSOM SHALL PROVIDE NKC INFORMATION REGARDING THE AMOUNT AND TYPE OF EXPENDITURES ASSOCIATED WITH GIFTS TO THE UWSOM. AT THE END OF THE PERIOD COVERED BY THIS GIFT AGREEMENT ANY UNSPENT NKC GIFT FUNDS TO UWSOM SHOULD REMAIN DESIGNATED FOR USE BY THE NEPHROLOGY FELLOWSHIP PROGRAM, BASIC RESEARCH ENDEAVORS, OR KIDNEY RESEARCH INSTITUTE FOR USE IN SUBSEQUENT FISCAL YEARS. ALL FUNDS REMAIN WITH UWSOM AS A GIFT FOR THE KRI. INDIVIDUAL GRANTS: THE EMERGENCY FUND PROGRAM PROVIDES SUPPORT FOR SELECT NORTHWEST KIDNEY CENTERS (NKC) PATIENTS CURRENTLY RECEIVING DIALYSIS, OR PATIENTS OF NKC WHO HAVE RECEIVED A KIDNEY TRANSPLANT WITHIN THE PREVIOUS THREE YEARS AND RESIDE WITHIN WASHINGTON STATE. GRANTS OF UP TO $250 PER PATIENT MAY BE AWARDED IN A GIVEN TWELVE MONTH PERIOD. PAYMENT IS IN THE FORM OF A CHECK OR GROCERY STORE GIFT CARD. REQUESTS FOR LARGER AMOUNTS WILL BE CONSIDERED INDIVIDUALLY ON AN EXCEPTION BASIS. NKC SOCIAL WORKERS ARE RESPONSIBLE FOR OBTAINING DOCUMENTATION OF THE PATIENT'S NEED AND INVESTIGATION OF ALL OTHER POSSIBLE COMMUNITY RESOURCES AVAILABLE TO MEET THE NEED. EACH GRANT MUST BE APPROVED BY THE PATIENT'S SOCIAL WORKER, AND THE SOCIAL SERVICES DIRECTOR. THE GRANT WILL BE PAID TO A THIRD PARTY FOR THE SERVICE OR MATERIAL NEEDED BY THE PATIENT. CHECKS WILL NOT BE MADE OUT TO THE PATIENT DIRECTLY. SCHOLARSHIPS: EMPLOYEE SCHOLARSHIP APPLICATIONS ARE REVIEWED BY DEVELOPMENT STAFF TO ENSURE APPLICATIONS ARE COMPLETE, AND BY HUMAN RESOURCES (HR) TO ENSURE APPLICANTS MEET MINIMUM QUALIFICATIONS (EMPLOYED AT LEAST ONE YEAR, FULL-TIME OR REGULAR PART-TIME (AT LEAST 24 HOURS PER WEEK)). THOSE WHO MEET MINIMUM QUALIFICATIONS ARE SENT TO THE EMPLOYEE SCHOLARSHIP COMMITTEE TO BE RATED USING A SCORING MATRIX OF SPECIFIC CRITERIA. THE COMMITTEE IS COMPRISED OF AN HR REPRESENTATIVE, CKD PROGRAM MANAGER (MSW) AND VP DEVELOPMENT. THE HIGHEST RATED APPLICANTS THEN INTERVIEW WITH THE COMMITTEE. AFTER THAT, THE COMMITTEE DECIDES WHO WILL RECEIVE A SCHOLARSHIP AND HOW MUCH. THE ACTUAL AMOUNTS AWARDED DEPEND ON RESTRICTIONS PLACED BY THE DONORS ABOUT HOW THE SCHOLARSHIP FUNDS CAN BE USED AND THE AMOUNT AVAILABLE IN ANY GIVEN YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PART II, LINE 1, COLUMN H:</FormAndLineReferenceDesc>
        <ExplanationTxt>RESEARCH GRANTS ARE AWARDED TO UNIVERSITY PHYSICIANS WHO ARE CONDUCTING STUDIES, WHICH ARE DEDICATED TO RESEARCHING CAUSES AND CURES OF CONDITIONS RELATING TO KIDNEY DISEASES. FELLOWSHIPS ARE AWARDED TO THE UNIVERSITY OF WASHINGTON TO PROVIDE SALARY FUNDS FOR PHYSICIANS IN TRAINING TO BECOME NEPHROLOGISTS WHO CARE FOR PATIENTS WITH KIDNEY DISEASE. THE KIDNEY RESEARCH INSTITUTE IS A UNIVERSITY OF WASHINGTON BASED ORGANIZATION THAT IS DEDICATED TO THE RESEARCH OF KIDNEY DISEASE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>1</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>REBECCA FOX</PersonNm>
        <TitleTxt>CEO &amp; PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>533591</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>80077</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1263</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11781</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18878</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>645590</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUZANNE WATNICK</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>403544</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>48907</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1239</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12200</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7895</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>473785</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ELIZABETH MCNAMARA</PersonNm>
        <TitleTxt>CHIEF ADMINISTRATIVE OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>302789</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>25245</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1826</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12112</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>341972</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JANE SINFUEGO</PersonNm>
        <TitleTxt>REGISTERED NEPHROLOGY NURSE</TitleTxt>
        <BaseCompensationFilingOrgAmt>241832</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>2500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1189</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9510</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8518</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>263549</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TODD BUI</PersonNm>
        <TitleTxt>REGISTERED NEPHROLOGY NURSE</TitleTxt>
        <BaseCompensationFilingOrgAmt>242414</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>2500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>110</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7353</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7895</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>260272</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TANYA WOLFF</PersonNm>
        <TitleTxt>REGISTERED NEPHROLOGY NURSE</TitleTxt>
        <BaseCompensationFilingOrgAmt>217248</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>2500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>974</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7400</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7895</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>236017</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS MONTEMAYOR</PersonNm>
        <TitleTxt>PHARMACY MANAGER</TitleTxt>
        <BaseCompensationFilingOrgAmt>208878</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>358</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>586</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7710</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7895</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>225427</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL TRIOMPO</PersonNm>
        <TitleTxt>PROJECT MANAGER</TitleTxt>
        <BaseCompensationFilingOrgAmt>206070</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1010</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8267</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8518</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>223865</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TONIA CAMPBELL</PersonNm>
        <TitleTxt>FORMER CFO &amp; TREASURER THRU 6/22</TitleTxt>
        <BaseCompensationFilingOrgAmt>151351</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>47616</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>11333</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>210300</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBIN LARMER</PersonNm>
        <TitleTxt>VP LEGAL AFFAIRS, CCO, &amp; SECRETARY</TitleTxt>
        <BaseCompensationFilingOrgAmt>154223</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>33608</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1786</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7882</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>197499</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>TONIA CAMPBELL RECEIVED $46,154 OF SEVERENCE PAYMENTS IN 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CEO &amp; PRESIDENT PARTICIPATES IN AN INCENTIVE PLAN DESIGNED FOR THIS OFFICE-HOLDER ALONE. THE PURPOSE OF THIS PLAN IS TO ALIGN THE PRESIDENT'S INTERESTS WITH THOSE OF THE BOARD AND NKC'S BROADER CONSTITUENTS AND TO RECOGNIZE SPECIAL CONTRIBUTIONS TO NKC'S FINANCIAL AND OPERATIONAL SUCCESS. THE COMPENSATION COMMITTEE OF THE BOARD HAS BOARD-DELEGATED RESPONSIBILITY FOR ESTABLISHING THE TOTAL COMPENSATION PACKAGE FOR THE CEO, AND FOR APPROVING THE CEO'S COMPENSATION PACKAGE. THE COMPENSATION COMMITTEE MEETS ANNUALLY TO ESTABLISH REASONABLE FINANCIAL AND OTHER GOALS FOR THE COMING YEAR. AT THE CONCLUSION OF THE YEAR, THE COMPENSATION COMMITTEE REVIEWS PERFORMANCE COMPARED TO THE PREDETERMINED GOALS, DETERMINES APPROPRIATE INCENTIVE COMPENSATION AS REASONABLY DETERMINED BY THE COMMITTEE AT ITS DISCRETION AND APPROVES GOALS FOR THE FOLLOWING YEAR. THE CHAIR OR HIS OR HER DESIGNATE WILL MEET WITH THE CEO TO REVIEW PRIOR YEAR PERFORMANCE AND THE CORRESPONDING INCENTIVE AWARD AND THE COMING YEAR'S FINANCIAL AND OPERATIONAL GOALS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>WASHINGTON HEALTH CARE FACILITIES AUTHORITY 2021 SERIES A</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>911108929</BondIssuerEIN>
        <CUSIPNum>NONEAVAIL</CUSIPNum>
        <BondIssuedDt>2021-05-31</BondIssuedDt>
        <IssuePriceAmt>51300000</IssuePriceAmt>
        <PurposeDesc>PREVIOUS PAY OFF, ISSUANCE COSTS</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>WASHINGTON HEALTH CARE FACILITIES AUTHORITY 2021 SERIES B</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>911108929</BondIssuerEIN>
        <CUSIPNum>NONEAVAIL</CUSIPNum>
        <BondIssuedDt>2021-05-31</BondIssuedDt>
        <IssuePriceAmt>28600000</IssuePriceAmt>
        <PurposeDesc>PREVIOUS PAY OFF, CAPITAL IMPROVEMENTS</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>51300000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>1190500</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>50109500</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceedsAmt>28600000</TotalProceedsAmt>
        <CapitalExpendituresAmt>27520000</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>1080000</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <SecuritiesPubliclyTradedGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>3</ContributionCnt>
        <NoncashContributionsRptF990Amt>41540</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>ESTIMATED FAIR VALUE</MethodOfDeterminingRevenuesTxt>
      </SecuritiesPubliclyTradedGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>AUCTION ITEMS</Desc>
        <ContributionCnt>80</ContributionCnt>
        <NoncashContributionsRptF990Amt>117622</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>ESTIMATED FAIR VALUE</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>1</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, COLUMN (B):</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NUMBER IN PART I, COLUMN (B) FOR SECURITIES REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FOR AUCTION ITEMS, THE NUMBER OF ITEMS CONTRIBUTED.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>NORTHWEST KIDNEY CENTERS (NKC) IS LED BY A VOLUNTEER BOARD OF TRUSTEES AND BY A FOUNDATION BOARD THAT HELPS RAISE MONEY AND MAKE CONNECTIONS. THEY ARE JOINED BY SEVERAL HUNDRED OTHER VOLUNTEERS AS NEEDED TO STAFF EVENTS FOCUSED ON FUNDRAISING OR BUILDING COMMUNITY SUPPORT. DURING FISCAL YEAR 2023, NKC PARTICIPATED IN OR PRODUCED 55 TOTAL OUTREACH ACTIVITIES, INCLUDING 35 COMMUNITY EVENTS AND 20 SPEAKING ENGAGEMENTS, ENABLING NKC TO REACH A COMBINED TOTAL OF 6,580 PEOPLE THROUGHOUT THE YEAR. THIS WAS ACCOMPLISHED WITH THE GENEROUS SUPPORT OF 520 VOLUNTEERS WHO CONTRIBUTED 4,030 HOURS OF THEIR TIME TO HELPING NKC IN MULTIPLE WAYS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF TRUSTEES' FINANCE AUDIT AND INVESTMENT COMMITTEE REVIEWED THE 2022 FORM 990 BEFORE IT WAS FILED. THE 2022 FORM 990 WAS AVAILABLE TO THE FULL BOARD OF TRUSTEES BEFORE IT WAS FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REQUIRES ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS AND MANAGERS ANNUALLY TO DISCLOSE FINANCIAL INTERESTS AND PERSONAL RELATIONSHIPS WITH POTENTIAL TO GIVE RISE TO A CONFLICT. ALL DISCLOSURES ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER, THE CHAIR OF THE BOARD COMPLIANCE COMMITTEE, AND THE PRESIDENT/CEO. THE CHIEF COMPLIANCE OFFICER AND CHAIR OF THE BOARD'S COMPLIANCE COMMITTEE DECIDE WHAT, IF ANY, POTENTIAL CONFLICTS EXIST, AND REPORT ANY SUCH CONFLICTS TO THE BOARD OF TRUSTEES. THE CHIEF COMPLIANCE OFFICER AND BOARD COMPLIANCE COMMITTEE CHAIR FOLLOW UP WITH INDIVIDUALS WITH IDENTIFIED POTENTIAL CONFLICTS TO ESTABLISH AND IMPLEMENT ANY NECESSARY SAFEGUARDS. INDIVIDUAL BOARD MEMBERS ARE REMINDED TO ABSTAIN FROM VOTES IF THERE IS A POTENTIAL CONFLICT OF INTEREST. THE CONFLICT OF INTEREST POLICY IS SHARED WITH ALL NEW EMPLOYEES AND NEW BOARD AND BOARD COMMITTEE MEMBERS AND IT IS POSTED ON NORTHWEST KIDNEY CENTERS' INTRANET.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>NORTHWEST KIDNEY CENTERS BOARD OF TRUSTEES' COMPENSATION COMMITTEE REVIEWS THE PRESIDENT/CEO'S COMPENSATION. THE COMMITTEE CONSISTS OF THREE INDEPENDENT BOARD MEMBERS WHO DO NOT RECEIVE ANY COMPENSATION FROM NORTHWEST KIDNEY CENTERS. THIS COMMITTEE CONTRACTS WITH AN INDEPENDENT FIRM TO EVALUATE THE ORGANIZATION'S COMPLIANCE WITH FIDUCIARY AND IRS RULES AND RESPONSIBILITIES. THIS OUTSIDE REVIEW USES HOSPITAL AND OTHER HEALTH CARE COMPENSATION DATA TO FORMULATE A RECOMMENDATION ON TOTAL COMPENSATION RELATIVE TO SIZE, COMPLEXITY, MARKET LOCATION, AND NATURE OF THE ORGANIZATION. THE COMPENSATION COMMITTEE IS DELEGATED BY THE BOARD OF TRUSTEES TO APPROVE A SALARY FOR THE PRESIDENT/CEO. THE PROCESS WAS PERFORMED IN 2023 FOR THE COMPENSATION PACKAGE OF THE PRESIDENT/CEO. DATA REGARDING THE VICE PRESIDENTS' PAY HISTORY, CURRENT PAY AND PROPOSED ADJUSTMENTS WERE PROVIDED TO THE NORTHWEST KIDNEY CENTERS COMPENSATION COMMITTEE, WHO DETERMINE THAT SUCH AMOUNTS ARE CONSISTENT WITH MARKET PARAMETERS. COMPENSATION FOR THE VICE PRESIDENTS WAS LAST REVIEWED IN 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S BYLAWS, ARTICLES OF INCORPORATION, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE ON REQUEST, CONTACT INFO@NWKIDNEY.ORG. THE FISCAL YEAR FINANCIAL RESULTS ARE PUBLISHED IN THE ANNUAL REPORT, AVAILABLE ON WWW.NWKIDNEY.ORG.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -59,312. PRIOR YEAR PLEDGES WRITTEN OFF -7,731. WRITE-OFF OF NEGATIVE EQUITY INTEREST IN RELATED ORG. -129,270.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043500001">
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>NORTHWEST KIDNEY CARE ALLIANCE</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 3037</AddressLine1Txt>
          <CityNm>SEATTLE</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>981143037</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>ENHANCE QUALITY &amp; REDUCE COST OF HEALTH CARE SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NORTHWEST KIDNEY CENTERS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>-35287</ShareOfTotalIncomeAmt>
        <OwnershipPct>0.50000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
