<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2021v4.1" xsi:schemaLocation="http://www.irs.gov/efile">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-05-12T17:08:07-07:00</ReturnTs>
    <TaxPeriodEndDt>2022-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>330278891</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Oscar G Armijo CPA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>41-990 Cook St Suite 501</AddressLine1Txt>
        <CityNm>Palm Desert</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>92211</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2021-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>942652757</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Clinica De Salud Del Valle De Salinas</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>CLIN</BusinessNameControlTxt>
      <PhoneNum>8317578689</PhoneNum>
      <USAddress>
        <AddressLine1Txt>55 Plaza Circle Suite A</AddressLine1Txt>
        <CityNm>Salinas</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>93901</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Harold Mccoy</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <SignatureDt>2023-05-12</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>Harold</PersonFirstNm>
        <PersonLastNm>Mccoy</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Oscar G Armijo CPA</PreparerPersonNm>
      <PTIN>P01429445</PTIN>
      <PhoneNum>7607734078</PhoneNum>
      <SelfEmployedInd>X</SelfEmployedInd>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
        <FederatedAssuranceLevelCd>FAL1</FederatedAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2021</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="IRS990" referenceDocumentId="IRS990ScheduleO" softwareId="21013475" softwareVersionNum="2021v4.1">
      <USAddress>
        <AddressLine1Txt>55 Plaza Circle Suite A</AddressLine1Txt>
        <CityNm>Salinas</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>93901</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>46387391</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.csvs.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1980</FormationYr>
      <LegalDomicileStateCd>CA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Clinica de Salud de Valle de Salinas is dedicated to providing comprehensive healthcare to the men, women, and children with an emphasis on working with farmworker families and the agriculture community.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>9</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>379</TotalEmployeeCnt>
      <TotalVolunteersCnt>9</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>17506874</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>10278466</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>29671617</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>34950059</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1676226</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>947844</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>303278</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>211022</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>49157995</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>46387391</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>27944926</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>28918766</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>13557296</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>12416024</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>41502222</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>41334790</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>7655773</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>5052601</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>59885371</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>66733112</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>12060912</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>17486461</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>47824459</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>49246651</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>Clinica de Salud de Valle de Salinas is dedicated to providing comprehensive healthcare to the men, women, and children with an emphasis on working with farmworker families and the agriculture community.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>29630046</ExpenseAmt>
      <RevenueAmt>34950059</RevenueAmt>
      <Desc>Provided affordable health, dental, and vision care to medically underserved residents of Monterey County. Patient visits for the year were 189,608.</Desc>
      <TotalProgramServiceExpensesAmt>29630046</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="IRS990ScheduleD">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="IRS990ScheduleD">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="IRS990ScheduleD">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="IRS990ScheduleD">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="IRS990ScheduleD">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>46</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>379</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <Form8282FiledCnt>0</Form8282FiledCnt>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>9</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>CA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <OtherInd>X</OtherInd>
      <BooksInCareOfDetail>
        <PersonNm>Harold M McCoy</PersonNm>
        <PhoneNum>8317578689</PhoneNum>
        <USAddress>
          <AddressLine1Txt>440 Airport Drive Suite A</AddressLine1Txt>
          <CityNm>Salinas</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93905</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jon Yoshiyama</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>455553</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>50351</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Bob Peng</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>453412</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43071</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maximiliano Cuevas</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>457456</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24351</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Harold Mccoy</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>432868</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16875</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Oguchi Nkwocha</PersonNm>
        <TitleTxt>Chief Medical Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>349753</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24351</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Terrence Charles Hack</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>344529</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25124</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Pablo S Marchevsky</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>311532</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43851</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Victor Otto Brooks</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>288640</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16875</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>William Huerta Jr</PersonNm>
        <TitleTxt>Dental Director</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>208607</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8335</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>William Douglass Evans Jr</PersonNm>
        <TitleTxt>Chief Information Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>176647</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16875</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Criselia Serrano</PersonNm>
        <TitleTxt>Vice President</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Raymond Gonzalez</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rogelio Jacinto</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Elizabeth Reyes</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Ali Chavez</PersonNm>
        <TitleTxt>President</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Genaro Carlos</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Aurelio Gonzalez</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maria P Aguilar</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Victoria Coley</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3478997</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>270059</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>38</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Armando Alcantara</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>111 Dolores St</AddressLine1Txt>
            <CityNm>Salinas</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93905</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Handyman Services</ServicesDesc>
        <CompensationAmt>174967</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Purserve Building Services Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>Po Box 698</AddressLine1Txt>
            <CityNm>Salinas</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93902</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Janitorial Services</ServicesDesc>
        <CompensationAmt>361533</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Fenton &amp; Keller</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 791</AddressLine1Txt>
            <CityNm>Monterey</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93942</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Legal Services</ServicesDesc>
        <CompensationAmt>160157</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Kysmet Security &amp; Patrol</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>21 W Laurel Dr SUite 49</AddressLine1Txt>
            <CityNm>Salinas</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93908</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Security</ServicesDesc>
        <CompensationAmt>128617</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Strategic Resource Network</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 955</AddressLine1Txt>
            <CityNm>Del Mar</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92014</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Management Consultant</ServicesDesc>
        <CompensationAmt>131819</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>8</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>10114976</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>163490</AllOtherContributionsAmt>
      <TotalContributionsAmt>10278466</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>COVID-19 Service Fee</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>171960</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>171960</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Fees</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>34753826</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>34753826</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Pharmacy Fees</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>24273</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24273</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>34950059</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>947844</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>947844</RelatedOrExemptFuncIncomeAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>118345</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>118345</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>118345</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>118345</RelatedOrExemptFuncIncomeAmt>
      </NetRentalIncomeOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>Other Income</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>92677</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>92677</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>92677</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>46387391</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>36108925</RelatedOrExemptFuncIncomeAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1777512</TotalAmt>
        <ManagementAndGeneralAmt>1777512</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>21587625</TotalAmt>
        <ProgramServicesAmt>19160929</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2426696</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>470292</TotalAmt>
        <ProgramServicesAmt>269378</ProgramServicesAmt>
        <ManagementAndGeneralAmt>200914</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3428291</TotalAmt>
        <ProgramServicesAmt>1963683</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1464608</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1655046</TotalAmt>
        <ProgramServicesAmt>947990</ProgramServicesAmt>
        <ManagementAndGeneralAmt>707056</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>275658</TotalAmt>
        <ManagementAndGeneralAmt>275658</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>117787</TotalAmt>
        <ManagementAndGeneralAmt>117787</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>120903</TotalAmt>
        <ManagementAndGeneralAmt>120903</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1111926</TotalAmt>
        <ProgramServicesAmt>928823</ProgramServicesAmt>
        <ManagementAndGeneralAmt>183103</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>0</TotalAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>0</TotalAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>165046</TotalAmt>
        <ManagementAndGeneralAmt>165046</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>0</TotalAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>0</TotalAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>596585</TotalAmt>
        <ProgramServicesAmt>371753</ProgramServicesAmt>
        <ManagementAndGeneralAmt>224832</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>1055165</TotalAmt>
        <ProgramServicesAmt>479091</ProgramServicesAmt>
        <ManagementAndGeneralAmt>576074</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Other Expenses</Desc>
        <TotalAmt>2944763</TotalAmt>
        <ProgramServicesAmt>1661290</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1283473</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Consumable Supplies</Desc>
        <TotalAmt>1699115</TotalAmt>
        <ProgramServicesAmt>1689003</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10112</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Equipment &amp; Software</Desc>
        <TotalAmt>1518200</TotalAmt>
        <ProgramServicesAmt>733156</ProgramServicesAmt>
        <ManagementAndGeneralAmt>785044</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Repairs &amp; Maintenance</Desc>
        <TotalAmt>1216712</TotalAmt>
        <ProgramServicesAmt>670913</ProgramServicesAmt>
        <ManagementAndGeneralAmt>545799</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>1594164</TotalAmt>
        <ProgramServicesAmt>754037</ProgramServicesAmt>
        <ManagementAndGeneralAmt>840127</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>41334790</TotalAmt>
        <ProgramServicesAmt>29630046</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11704744</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>10397474</BOYAmt>
        <EOYAmt>17795759</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>560132</BOYAmt>
        <EOYAmt>851636</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>11890590</BOYAmt>
        <EOYAmt>8591649</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>3446628</BOYAmt>
        <EOYAmt>2725806</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>15234</BOYAmt>
        <EOYAmt>310666</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>25589707</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>8936646</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>11122800</BOYAmt>
        <EOYAmt>16653061</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>22158056</BOYAmt>
        <EOYAmt>19209480</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>294457</BOYAmt>
        <EOYAmt>595055</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>59885371</BOYAmt>
        <EOYAmt>66733112</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>4646451</BOYAmt>
        <EOYAmt>5431572</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>4114461</BOYAmt>
        <EOYAmt>8454889</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>3300000</BOYAmt>
        <EOYAmt>3600000</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>12060912</BOYAmt>
        <EOYAmt>17486461</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>36722079</BOYAmt>
        <EOYAmt>39455292</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>11102380</BOYAmt>
        <EOYAmt>9791359</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>47824459</BOYAmt>
        <EOYAmt>49246651</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>59885371</BOYAmt>
        <EOYAmt>66733112</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>5052601</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-3602575</NetUnrlzdGainsLossesInvstAmt>
      <PriorPeriodAdjustmentsAmt>-27834</PriorPeriodAdjustmentsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="21013475" softwareVersionNum="2021v4.1">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>8315987</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8253632</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>15960224</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>17506874</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10278466</CurrentTaxYearAmt>
        <TotalAmt>60315183</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TaxRevLeviedOrgnztnlBnft170Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft170Grp>
      <GovtFurnSrvcFcltsVl170Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>8315987</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8253632</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>15960224</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>17506874</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10278466</CurrentTaxYearAmt>
        <TotalAmt>60315183</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>0</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>60315183</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>877831</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1460217</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1281847</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1676226</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1066189</CurrentTaxYearAmt>
        <TotalAmt>6362310</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <TotalAmt>0</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>33296</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>72915</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>360660</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>303278</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>92677</CurrentTaxYearAmt>
        <TotalAmt>862826</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>67540319</TotalSupportAmt>
      <PublicSupportCY170Pct>0.89300</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.90120</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="21013475" softwareVersionNum="2021v4.1">
      <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>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="21013475" softwareVersionNum="2021v4.1">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>1834055</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1834055</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>9839381</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4416922</DepreciationAmt>
        <BookValueAmt>5422459</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>297194</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>297194</DepreciationAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>6110239</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4062066</DepreciationAmt>
        <BookValueAmt>2048173</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>7508838</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>160464</DepreciationAmt>
        <BookValueAmt>7348374</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>16653061</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated Third Party Liability</Desc>
        <Amt>3600000</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>3600000</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>42663913</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-3602575</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-3602575</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>46266488</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>120903</InvestmentExpensesNotIncldAmt>
      <RevenueNotReportedFinclStmtAmt>120903</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>46387391</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>41213887</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>41213887</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>120903</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>120903</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>41334790</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="21013475" softwareVersionNum="2021v4.1">
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <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>Bob Peng</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>453412</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>18720</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>24351</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>496483</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Harold Mccoy</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>312221</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>120647</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>16875</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>449743</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jon Yoshiyama</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>425690</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>29863</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>26000</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>24351</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>505904</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Maximiliano Cuevas</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>334165</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>123291</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>24351</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>481807</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Oguchi Nkwocha</PersonNm>
        <TitleTxt>Chief Medical Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>349378</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>375</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>24351</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>374104</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Pablo S Marchevsky</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>311157</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>375</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>19500</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>24351</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>355383</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Terrence Charles Hack</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>327691</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>16838</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>773</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>24351</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>369653</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Victor Otto Brooks</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>288640</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16875</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>305515</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>William Douglass Evans Jr</PersonNm>
        <TitleTxt>Chief Information Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>176647</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16875</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>193522</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>William Huerta Jr</PersonNm>
        <TitleTxt>Dental Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>205369</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>3238</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>8335</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>216942</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a: Relevant information in regards to selections on 1a.</FormAndLineReferenceDesc>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7: Non-Fixed payments not listed above</FormAndLineReferenceDesc>
        <ExplanationTxt>Nonfixed payments include bonuses and incentives and other contractual compensation. Incentives and bonuses are tied to patient care incentives, organizational performance measures, provider productivity and other contract related provisions. Other contractual compensation primarily includes hospital pay, extra days and Saturdays worked by providers, and taxable group life insurance.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="21013475" softwareVersionNum="2021v4.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is prepared and filed by an independent CPA. Prior to filing, the 990 is reviewed by the controller and CFO before sending to the Board of Directors for their review.</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 in accordance with the written policies and procedures. The Organization reviews conflict of interest policy every two years.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation surveys are performed by the director of human resources using state and national databases. The board of directors determines the CEO compensation based upon surveys and other comparable data.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO and Director of Human Resources determine the compensation for other officers and highly compensated employees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 18: Explanation of Other Means Forms Available For Public Inspection</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is available for review upon written request at the organization's administrative office during normal business hours.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing Docs, Policies, and Financial statements are available for review upon written request at the organization's administrative office during normal business hours.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
