The definition of "Patient.managingOrganization" in section 8.1.2 is inconsistent with the defintion of the search parameter based on this data element (i.e. "organization") -its unclear if the Patient.managingOrganization is the "custodian" (that could be an HIE) or "treating" organization where the patient is treated (e.g. clinic, hospital):

managingOrganization ?0..1[Reference|http://hl7.org/fhir/2018May/references.html]([Organization|http://hl7.org/fhir/2018May/organization.html])

Organization that is the custodian of the patient record

vs.

organization referenceT*he organization at which this person is a patient *Patient.managingOrganization
(Organization)