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      <Form990PartVIISectionAGrp>
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        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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      <Form990PartVIISectionAGrp>
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        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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          <BusinessName>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>DC</StateAbbreviationCd>
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        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
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        </ContractorName>
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          <USAddress>
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        </ContractorAddress>
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      <ProgramServiceRevenueGrp>
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      <ProgramServiceRevenueGrp>
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      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>320881</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT SERVICES</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>162965</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>5197706</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>67160</TotalRevenueColumnAmt>
        <ExclusionAmt>67160</ExclusionAmt>
      </InvestmentIncomeGrp>
      <LessCostOthBasisSalesExpnssGrp>
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      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
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      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-554</TotalRevenueColumnAmt>
        <ExclusionAmt>-554</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>5284312</TotalRevenueColumnAmt>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>66606</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>858639</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>1744841</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>58181</TotalAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>80398</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>194642</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>117059</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>11150</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
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      <FeesForServicesOtherGrp>
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      <AdvertisingGrp>
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      <OfficeExpensesGrp>
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      <InformationTechnologyGrp>
        <TotalAmt>105404</TotalAmt>
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      <OccupancyGrp>
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      </OccupancyGrp>
      <TravelGrp>
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      <ConferencesMeetingsGrp>
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      <DepreciationDepletionGrp>
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      <InsuranceGrp>
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        <Desc>POLITICAL EDUCATION</Desc>
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      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS EXPENSE</Desc>
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      <OtherExpensesGrp>
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      <InventoriesForSaleOrUseGrp>
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      <PrepaidExpensesDefrdChargesGrp>
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      <TotalAssetsGrp>
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      <AccountsPayableAccrExpnssGrp>
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      <OtherLiabilitiesGrp>
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        <EOYAmt>59433</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>397101</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
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        <EOYAmt>3260270</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
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        <EOYAmt>3260270</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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      <ReconcilationRevenueExpnssAmt>246339</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleB documentId="RetDoc1234500001">
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        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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      <AgreeCarryoverPriorYearInd>0</AgreeCarryoverPriorYearInd>
      <DuesAssessmentsAmt>2699266</DuesAssessmentsAmt>
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      <BuildingsGrp>
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      </BuildingsGrp>
      <EquipmentGrp>
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        <DepreciationAmt>199228</DepreciationAmt>
        <BookValueAmt>116700</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
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      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>1343658</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITY</Desc>
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      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ASSOCIATION IS QUALIFIED AS EXEMPT ORGANIZATIONS WITHIN THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(6), AND IS NOT SUBJECT TO INCOME TAXES. MANAGEMENT HAS EVALUATED THE ASSOCIATION'S MATERIAL TAX POSITIONS AND DETERMINED NO INCOME TAX EFFECTS ARE NECESSARY WITH RESPECT TO THE FINANCIAL STATEMENTS. THE ASSOCIATION HAS NOT BEEN NOTIFIED OF ANY IMPENDING EXAMINATIONS BY TAX AUTHORITIES AND NO EXAMINATIONS ARE IN PROCESS.</ExplanationTxt>
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    </IRS990ScheduleD>
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      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
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        <PersonNm>BRENT WILLETT</PersonNm>
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        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>17500</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>41641</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>858639</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MEREA BENTROTT</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <DeferredCompensationFlngOrgAmt>17500</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MEGAN STOULIL</PersonNm>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>7623</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>170809</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRENDA IRLBECK</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>170084</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ASSOCIATION IS ORGANIZED INTO THREE CLASSES OF MEMBERS: INSTITUTIONAL, ASSOCIATE AND HONORARY. ONLY INSTITUTIONAL MEMBERS HAVE THE RIGHT TO VOTE OF VOTE ON APPLICABLE MATTERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>INSTITUTIONAL MEMBERS ELECT VARIOUS MEMBERS OF THE BOARD OF DIRECTORS ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BYLAWS MAY BE AMENDED BY THE BOARD OF DIRECTORS AT ANY REGULAR MEETING OR ANY SPECIAL MEETING CALLED FOR THAT PURPOSE AT WHICH A MAJORITY OF THE BOARD OF DIRECTORS PRESENT VOTE FOR SUCH AMENDMENTS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REQUIRES EACH DIRECTOR TO ANNUALLY COMPLETE A DISCLOSURE STATEMENT WHICH IDENTIFIES ANY POTENTIAL CONFLICT OF INTEREST THAT A DIRECTOR MAY HAVE. THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY BASED ON RESPONSES RECEIVED ON THE DISCLOSURE STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE DIRECTOR'S SALARY, ALONG WITH KEY EMPLOYEE SALARIES, ARE REVIEWED AND APPROVED BY DESIGNATED BOARD MEMBERS CHARGED WITH THE PROCESS OF DETERMINING COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTINUING EDUCATION PROGRAMS 308,998. PROFESSIONAL FEES 162,218. PAYROLL ADMINISTRATIVE FEES 60,349. REIMBURSEMENT CONSULTANT 45,280.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS NOT CHANGED ITS AUDIT OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>IOWA HEALTH CARE ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1775 90TH STREET</AddressLine1Txt>
          <CityNm>WEST DES MOINES</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>502667726</ZIPCd>
        </USAddress>
        <EIN>421326564</EIN>
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        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
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          <CityNm>WEST DES MOINES</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>502667726</ZIPCd>
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        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
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          <CityNm>WEST DES MOINES</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>502667726</ZIPCd>
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        <EIN>421479155</EIN>
        <PrimaryActivitiesTxt>PROVIDE SERVICES FOR MEMBER ORGANIZATIONS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
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      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
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          <StateAbbreviationCd>IA</StateAbbreviationCd>
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      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>1</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>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
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          <BusinessNameLine1Txt>ECSI INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>150000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ECSI INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>94594</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ECSI INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>147542</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>IOWA HEALTH CARE ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>18500</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>IOWA HEALTH CARE ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>12965</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>