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        <BookValueAmt>670293</BookValueAmt>
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      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>3370</OtherCostOrOtherBasisAmt>
        <BookValueAmt>3370</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>4152312</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Settlements</Desc>
        <Amt>5221456</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>5221456</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>26984077</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>26984077</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>26984077</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>26458888</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>26458888</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>26458888</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X : FIN48 Footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization has been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. However, the Organization is subject to federal income tax on any unrelated business taxable income.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="18007218" softwareVersionNum="2018v3.1">
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      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
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      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RebuttablePresumptionProcInd>false</RebuttablePresumptionProcInd>
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        <PersonNm>Ara Airapetian MD</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>331863</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>11000</DeferredCompensationFlngOrgAmt>
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        <PersonNm>Arthur Manoukian</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>David Lontok</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Flora Poladyan</PersonNm>
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        <DeferredCompensationFlngOrgAmt>6644</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>4907</NontaxableBenefitsFilingOrgAmt>
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        <PersonNm>Grace Javellana</PersonNm>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jennifer Smith</PersonNm>
        <TitleTxt>VP of Compliance &amp; Risk Management</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>5791</DeferredCompensationFlngOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jenny Wang</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>211234</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8449</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>4777</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>224460</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Nairi Haroian MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>181543</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>4764</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>186307</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Oganes Paronian MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>234260</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8002</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>51</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>242313</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Scott Foust MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>189308</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7572</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>1219</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>198099</TotalCompensationFilingOrgAmt>
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    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="18007218" softwareVersionNum="2018v3.1">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>RE Ventures LLC</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>CEO/Member</RelationshipDescriptionTxt>
        <TransactionAmt>1147855</TransactionAmt>
        <TransactionDesc>Rent, Facilities,R&amp;M</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Chevy Chase Medical Plaza LLC</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>CEO/Member</RelationshipDescriptionTxt>
        <TransactionAmt>2380785</TransactionAmt>
        <TransactionDesc>Rent, Facilities,R&amp;M</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Rio Hondo Medical Plaza</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>CEO/Member</RelationshipDescriptionTxt>
        <TransactionAmt>12420</TransactionAmt>
        <TransactionDesc>Rent</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
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    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="18007218" softwareVersionNum="2018v3.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>BEFORE FILING THE 990, THE BOARD APPROVES THE 990 AND DOCUMENTS THE APPROVAL IN THE BOARD MINUTES OR A DRAFT COPY IS SENT TO THE BOARD FOR REVIEW AND DISCUSSED IN THE FOLLOWING MONTHS BOARD MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>CCHC enforces compliance with the conflict of interest policy by asking the key employees and the Board of Directors to annually sign the conflict of interest disclosure policy, thus monitoring and updating the interest of the employees and the Board of Directors for conflicts that might arise.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</FormAndLineReferenceDesc>
        <ExplanationTxt>We look at comparables by looking at other institutions 990 of the same size. We look at the instution reports like the NACHC booklet and MGMA. There is an annual evaluation of the key employees by the CEO. The CEO is evaluated by the Board and the Board determines the CEO's compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>We look at comparables by looking at other institutions 990 of the same size. We look at the instution reports like the NACHC booklet and MGMA. There is an annual evaluation of the key employees by the CEO. The CEO is evaluated by the Board and the Board determines the CEO's compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents and conflict of interest statement are available upon request. The form 990 is available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Auto: Column (A) - Total = $25683; Column (B) - Program Services = $1031; Column (C) - Management &amp; General = $24094; Column (D) - Fundraising = $558</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Bank Charges: Column (A) - Total = $6311; Column (B) - Program Services = $32; Column (C) - Management &amp; General = $6279; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Collection Fees: Column (A) - Total = $24722; Column (B) - Program Services = $0; Column (C) - Management &amp; General = $24722; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Computer Expense: Column (A) - Total = $375230; Column (B) - Program Services = $115717; Column (C) - Management &amp; General = $258906; Column (D) - Fundraising = $607</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Continuing Education: Column (A) - Total = $8814; Column (B) - Program Services = $8763; Column (C) - Management &amp; General = $51; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Dues &amp; Subscriptions: Column (A) - Total = $88140; Column (B) - Program Services = $2264; Column (C) - Management &amp; General = $85876; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility Expense: Column (A) - Total = $424555; Column (B) - Program Services = $123004; Column (C) - Management &amp; General = $273569; Column (D) - Fundraising = $27982</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Health Education Supplies: Column (A) - Total = $6939; Column (B) - Program Services = $0; Column (C) - Management &amp; General = $6506; Column (D) - Fundraising = $433</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Incentive: Column (A) - Total = $24270; Column (B) - Program Services = $0; Column (C) - Management &amp; General = $23793; Column (D) - Fundraising = $477</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Janitorial Supplies: Column (A) - Total = $22507; Column (B) - Program Services = $20721; Column (C) - Management &amp; General = $1630; Column (D) - Fundraising = $156</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Janitorial: Column (A) - Total = $238074; Column (B) - Program Services = $203865; Column (C) - Management &amp; General = $31062; Column (D) - Fundraising = $3147</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Lab Fees: Column (A) - Total = $209372; Column (B) - Program Services = $209372; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Laundry &amp; Linen: Column (A) - Total = $1334; Column (B) - Program Services = $1334; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Loan Fees: Column (A) - Total = $10500; Column (B) - Program Services = $0; Column (C) - Management &amp; General = $10500; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Meetings &amp; Conventions: Column (A) - Total = $9011; Column (B) - Program Services = $340; Column (C) - Management &amp; General = $8485; Column (D) - Fundraising = $186</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Office Supplies: Column (A) - Total = $167693; Column (B) - Program Services = $94011; Column (C) - Management &amp; General = $69603; Column (D) - Fundraising = $4079</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Parking Expense: Column (A) - Total = $4260; Column (B) - Program Services = $4260; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Pension Admin Expense: Column (A) - Total = $294836; Column (B) - Program Services = $164960; Column (C) - Management &amp; General = $129238; Column (D) - Fundraising = $638</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Postage and Shipping: Column (A) - Total = $22798; Column (B) - Program Services = $3992; Column (C) - Management &amp; General = $18646; Column (D) - Fundraising = $160</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Recruitment &amp; HR Cost: Column (A) - Total = $34536; Column (B) - Program Services = $0; Column (C) - Management &amp; General = $34536; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Repairs &amp; Maintenance: Column (A) - Total = $96396; Column (B) - Program Services = $63409; Column (C) - Management &amp; General = $32850; Column (D) - Fundraising = $137</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Security: Column (A) - Total = $71853; Column (B) - Program Services = $70228; Column (C) - Management &amp; General = $1625; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Taxes &amp; Licenses: Column (A) - Total = $23952; Column (B) - Program Services = $23692; Column (C) - Management &amp; General = $260; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Telephone: Column (A) - Total = $197732; Column (B) - Program Services = $144296; Column (C) - Management &amp; General = $53436; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Training &amp; Staff Development: Column (A) - Total = $71000; Column (B) - Program Services = $0; Column (C) - Management &amp; General = $71000; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Transportation: Column (A) - Total = $248850; Column (B) - Program Services = $248850; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Utilities: Column (A) - Total = $75554; Column (B) - Program Services = $75554; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e: Other Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>X-Ray Expense: Column (A) - Total = $9812; Column (B) - Program Services = $9812; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>