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        <DepreciationAmt>11085652</DepreciationAmt>
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        <OtherCostOrOtherBasisAmt>5904044</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>236804</DepreciationAmt>
        <BookValueAmt>5667240</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>44983898</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated 3rd Party Overpayments</Desc>
        <Amt>10887986</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Other liabilities</Desc>
        <Amt>78815</Amt>
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      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>115844528</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-216961</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-216961</RevenueNotReportedAmt>
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      <InvestmentExpensesNotIncldAmt>129098</InvestmentExpensesNotIncldAmt>
      <RevenueNotReportedFinclStmtAmt>129098</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>116190587</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>109056084</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>109056084</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>129098</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>129098</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>109185182</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X : FIN48 Footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>The accounting standard on accounting for uncertainty in income taxes addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under the guidance, the Organization may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. Examples of tax positions include the tax-exempt status of the Organization and various positions related to the potential sources of unrelated business taxable income (UBIT). The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. There were no unrecognized tax benefits identified or recorded as liabilities for fiscal year 2020.</ExplanationTxt>
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    </IRS990ScheduleD>
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      <IdemnificationGrossUpPmtsInd>X</IdemnificationGrossUpPmtsInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Antonio Alatorre</PersonNm>
        <TitleTxt>CBDO</TitleTxt>
        <BaseCompensationFilingOrgAmt>250834</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>2500</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>513304</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>18903</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>6000</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>791541</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Anwar Ali Abbas</PersonNm>
        <TitleTxt>CIO</TitleTxt>
        <BaseCompensationFilingOrgAmt>197602</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1000</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>9000</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>207602</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Christina M Velasco</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>363441</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>2500</BonusFilingOrganizationAmount>
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        <DeferredCompensationFlngOrgAmt>19250</DeferredCompensationFlngOrgAmt>
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        <PersonNm>Gagan Pawar</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>14859</DeferredCompensationFlngOrgAmt>
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        <PersonNm>Heidi Lee Miller</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <PersonNm>Kelly Lynn Bennett</PersonNm>
        <TitleTxt>Human Resources Director</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Menashe Ehrenburg</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>14976</DeferredCompensationFlngOrgAmt>
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        <PersonNm>Roberto S Juarez</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>505537</BaseCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>19250</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12000</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1618712</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Ta Thuc Ngu Dinh</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <BonusFilingOrganizationAmount>2250</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>14427</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>410663</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Tihele L Walkousky</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>351081</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1500</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>13947</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>366528</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Todd Wayne Monroe</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>363708</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>2250</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>14322</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>380280</TotalCompensationFilingOrgAmt>
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        <FormAndLineReferenceDesc>Part I, Line 1a: Relevant information in regards to selections on 1a.</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7: Non-Fixed payments not listed above</FormAndLineReferenceDesc>
        <ExplanationTxt>Nonfixed payemnts include holiday and other bonuses. Holiday bonuses are given based on time worked at the company. At year end, the CEO will propose to the Board of Directors additional bonuses for management based on various company performance measures. The Board approves the amounts to award.</ExplanationTxt>
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    </IRS990ScheduleJ>
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      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>California Municipal Fina</BusinessNameLine1Txt>
        </IssuerName>
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        <CUSIPNum>13048VNU8</CUSIPNum>
        <BondIssuedDt>2020-03-19</BondIssuedDt>
        <IssuePriceAmt>71427330</IssuePriceAmt>
        <PurposeDesc>To construct health care facil</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
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      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
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        <CapitalizedInterestAmt>422466</CapitalizedInterestAmt>
        <IssuanceCostsFromProceedsAmt>927699</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>2471702</CapitalExpendituresAmt>
        <UnspentAmt>38345196</UnspentAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is prepared by an independent CPA and then reviewed by the CFO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization investigates potential conflicts of interest when they arise. Any violations are handled in accordance with the written policies and procedures.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</FormAndLineReferenceDesc>
        <ExplanationTxt>Every year the Board of Directors Finance Committee evaluates the CEO's performance and compensation. Annually The CEO and HR Director work together using state and nationally based salary surveys to compare the corporations officers' salaries to those of similar corporations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>Comparsion surveys are performed by the CEO and Human Resources Director using state and national databases. Annual reviews are performed by the Board of Directors for all officers, key employees, and other highly compensated employees.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is available for review at the organizations administrative office during normal business hours. Other forms such as governing documents, conflict of interest policy, and financial statements are internal corporate documents.</ExplanationTxt>
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    </IRS990ScheduleO>
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          <BusinessNameLine1Txt>AmericasHealth Plan Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1000 Town Center Drive Suite 410</AddressLine1Txt>
          <CityNm>Ventura</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93004</ZIPCd>
        </USAddress>
        <EIN>271073990</EIN>
        <PrimaryActivitiesTxt>Managed Care Health Plan</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingEntityName>
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        </DirectControllingEntityName>
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        <ShareOfEOYAssetsAmt>5319128</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MedPartners MSO Incorporated</BusinessNameLine1Txt>
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          <AddressLine1Txt>1040 Flynn Rd</AddressLine1Txt>
          <CityNm>Camarillo</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93012</ZIPCd>
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        <PrimaryActivitiesTxt>Insurance Billing</PrimaryActivitiesTxt>
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