<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2022v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-11-01T17:10:15-04:00</ReturnTs>
    <TaxPeriodEndDt>2022-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>821455657</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>FESTER &amp; CHAPMAN PLLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>9019 E BAHIA DR STE 100</AddressLine1Txt>
        <CityNm>SCOTTSDALE</CityNm>
        <StateAbbreviationCd>AZ</StateAbbreviationCd>
        <ZIPCd>85260</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>860285857</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>EL RIO SANTA CRUZ</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>NEIGHBORHOOD HEALTH CENTER INC</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>ELRI</BusinessNameControlTxt>
      <PhoneNum>5206703705</PhoneNum>
      <USAddress>
        <AddressLine1Txt>PO BOX 1231</AddressLine1Txt>
        <CityNm>TUCSON</CityNm>
        <StateAbbreviationCd>AZ</StateAbbreviationCd>
        <ZIPCd>85702</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>CLINT KUNTZ</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <PhoneNum>5206703707</PhoneNum>
      <SignatureDt>2023-11-01</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>CLINT</PersonFirstNm>
        <PersonLastNm>KUNTZ</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>false</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>RACHEL LOCKE CPA</PreparerPersonNm>
      <PTIN>P00450405</PTIN>
      <PhoneNum>6022643077</PhoneNum>
      <PreparationDt>2023-11-01</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="RetDoc3" referenceDocumentId="RetDoc8">
      <PrincipalOfficerNm>CLINT KUNTZ</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>450 W PASEO REDONDO</AddressLine1Txt>
        <CityNm>TUCSON</CityNm>
        <StateAbbreviationCd>AZ</StateAbbreviationCd>
        <ZIPCd>85745</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>254848185</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.ELRIO.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1973</FormationYr>
      <LegalDomicileStateCd>AZ</LegalDomicileStateCd>
      <ActivityOrMissionDesc>IMPROVING THE HEALTH OF OUR COMMUNITY THROUGH COMPREHENSIVE, ACCESSIBLE, AFFORDABLE, QUALITY AND COMPASSIONATE CARE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>17</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>17</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>2137</TotalEmployeeCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>35828296</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>30601452</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>174223887</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>206520290</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1319431</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>1085115</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>12688103</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>14535505</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>224059717</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>252742362</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>620310</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>133003549</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>146406285</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>1885709</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>75777345</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>88611542</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>209401204</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>235017827</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>14658513</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>17724535</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>174632326</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>197572761</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>67025397</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>75074607</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>107606929</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>122498154</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>IMPROVING THE HEALTH OF OUR COMMUNITY THROUGH COMPREHENSIVE, ACCESSIBLE, AFFORDABLE, QUALITY, AND COMPASSIONATE CARE.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>210601948</ExpenseAmt>
      <RevenueAmt>206520290</RevenueAmt>
      <Desc>PROVIDES HEALTHCARE AND RELATED SERVICES TO THE INDIGENT AND LOW-INCOME POPULATION OF TUCSON, ARIZONA.</Desc>
      <TotalProgramServiceExpensesAmt>210601948</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc10">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc4">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc4">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc4">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc4">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc4">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc4">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc4">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc4">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc4">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc4">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc4">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc4">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc4">true</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="RetDoc5">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="RetDoc6">true</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>false</InvestTaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="RetDoc7">true</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="RetDoc7">false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc9">true</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc9">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc9">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc9">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>125</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>2137</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>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>17</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>17</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>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>EL RIO SANTA CRUZ</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>NEIGHBORHOOD HEALTH CENTER INC</BusinessNameLine2Txt>
        </BusinessName>
        <PhoneNum>5206703705</PhoneNum>
        <USAddress>
          <AddressLine1Txt>450 W PASEO REDONDO</AddressLine1Txt>
          <CityNm>TUCSON</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>85701</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>NANCY JOHNSON</PersonNm>
        <TitleTxt>INTERIM CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>533105</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44748</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DOUGLAS SPEGMAN</PersonNm>
        <TitleTxt>CCO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>385327</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>54074</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RAJIV MODAK</PersonNm>
        <TitleTxt>CQO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>321857</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36392</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY RAGLOW</PersonNm>
        <TitleTxt>CMIO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>316089</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>46167</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSHUA CARZOLI</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>285478</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43514</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ENRIQUE SERNA</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROCIO GALVEZ-MARTINEZ</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALEC BERENS</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>6.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FRANCISCO MUNOZ</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT RAUH</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MELVIN PETE REISINGER</PersonNm>
        <TitleTxt>VICE TREASUR</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY SPOERL</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN FLAGG</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DINA ROJAS-SANCHEZ</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FRANK VALENZUELA</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HAL STRICH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.75</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHRYN S BEATTY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIRK SAUNDERS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>4.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY WRIGHT</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICAH MORTENSEN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MIGUEL ROJAS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLAUDIA ALBELAIS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLINT KUNTZ</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ZIAD HEMZAWI</PersonNm>
        <TitleTxt>PEDIATRICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>429174</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45900</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREW ARTHUR</PersonNm>
        <TitleTxt>PEDIATRICS M</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>422998</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>46886</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA SOLTANI</PersonNm>
        <TitleTxt>INTERNAL MED</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>415725</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42233</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOY MOCKBEE</PersonNm>
        <TitleTxt>FAMILY PRACT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>349276</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43797</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FELIPE PEREZ</PersonNm>
        <TitleTxt>PROFESSIONS</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>331085</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42619</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3790114</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>446330</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>10</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>REDAPT INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 31001-3443</AddressLine1Txt>
            <CityNm>PASADENA</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>91110</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TEMP SERVICES</ServicesDesc>
        <CompensationAmt>425508</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HYLAND SOFTWARE INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 846261</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>752846261</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT SERVICES</ServicesDesc>
        <CompensationAmt>369235</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AEROTECK PROFESSIONAL SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3689 COLLECTION CTR DR</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60693</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TEMP SERVICES</ServicesDesc>
        <CompensationAmt>335302</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TEKSYSTEMS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 198568</AddressLine1Txt>
            <CityNm>ATLANTA</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>303848568</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT TEMP SERVICE</ServicesDesc>
        <CompensationAmt>296549</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MARK B RAVEN</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2802 E 9TH STREET</AddressLine1Txt>
            <CityNm>TUCSON</CityNm>
            <StateAbbreviationCd>AZ</StateAbbreviationCd>
            <ZIPCd>85716</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LEGAL SERVICES</ServicesDesc>
        <CompensationAmt>269600</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>18</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>29524267</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>1077185</AllOtherContributionsAmt>
      <NoncashContributionsAmt>3861602</NoncashContributionsAmt>
      <TotalContributionsAmt>30601452</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICES FEES</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>206520290</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>206520290</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>206520290</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1156128</TotalRevenueColumnAmt>
        <ExclusionAmt>1156128</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2034810</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>2105823</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-71013</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-71013</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-71013</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>14535505</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>14535505</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>14535505</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>252742362</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>220984782</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>1156128</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1841857</TotalAmt>
        <ProgramServicesAmt>1650019</ProgramServicesAmt>
        <ManagementAndGeneralAmt>191838</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>118950888</TotalAmt>
        <ProgramServicesAmt>106561581</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12389307</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>4737679</TotalAmt>
        <ProgramServicesAmt>4244227</ProgramServicesAmt>
        <ManagementAndGeneralAmt>493452</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>12125616</TotalAmt>
        <ProgramServicesAmt>10862675</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1262941</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>8750245</TotalAmt>
        <ProgramServicesAmt>7838865</ProgramServicesAmt>
        <ManagementAndGeneralAmt>911380</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>444260</TotalAmt>
        <ManagementAndGeneralAmt>444260</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>165541</TotalAmt>
        <ManagementAndGeneralAmt>165541</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>2349348</TotalAmt>
        <ProgramServicesAmt>2050062</ProgramServicesAmt>
        <ManagementAndGeneralAmt>137480</ManagementAndGeneralAmt>
        <FundraisingAmt>161806</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>12044276</TotalAmt>
        <ProgramServicesAmt>11006949</ProgramServicesAmt>
        <ManagementAndGeneralAmt>207806</ManagementAndGeneralAmt>
        <FundraisingAmt>829521</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>818425</TotalAmt>
        <ProgramServicesAmt>714165</ProgramServicesAmt>
        <ManagementAndGeneralAmt>47893</ManagementAndGeneralAmt>
        <FundraisingAmt>56367</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>314436</TotalAmt>
        <ProgramServicesAmt>314436</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>337912</TotalAmt>
        <ProgramServicesAmt>337912</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>800527</TotalAmt>
        <ProgramServicesAmt>800527</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>6662106</TotalAmt>
        <ProgramServicesAmt>2500604</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4161502</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>602126</TotalAmt>
        <ProgramServicesAmt>602126</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SERVICES/SUPPLIES</Desc>
        <TotalAmt>53159014</TotalAmt>
        <ProgramServicesAmt>51227274</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1707810</ManagementAndGeneralAmt>
        <FundraisingAmt>223930</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>IN-KIND EXPENSES</Desc>
        <TotalAmt>3861602</TotalAmt>
        <ProgramServicesAmt>3861602</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES AND FEES</Desc>
        <TotalAmt>1590864</TotalAmt>
        <ProgramServicesAmt>1388203</ProgramServicesAmt>
        <ManagementAndGeneralAmt>93094</ManagementAndGeneralAmt>
        <FundraisingAmt>109567</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>1545505</TotalAmt>
        <ProgramServicesAmt>725121</ProgramServicesAmt>
        <ManagementAndGeneralAmt>315866</ManagementAndGeneralAmt>
        <FundraisingAmt>504518</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>3915600</TotalAmt>
        <ProgramServicesAmt>3915600</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>235017827</TotalAmt>
        <ProgramServicesAmt>210601948</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22530170</ManagementAndGeneralAmt>
        <FundraisingAmt>1885709</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>5485352</BOYAmt>
        <EOYAmt>3447977</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>41668970</BOYAmt>
        <EOYAmt>20926215</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>3891309</BOYAmt>
        <EOYAmt>3701023</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>11326332</BOYAmt>
        <EOYAmt>26076282</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>23562325</BOYAmt>
        <EOYAmt>23562325</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>782788</BOYAmt>
        <EOYAmt>1247608</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>2086313</BOYAmt>
        <EOYAmt>2504597</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>115100017</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>58836791</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>60455009</BOYAmt>
        <EOYAmt>56263226</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>8616246</BOYAmt>
        <EOYAmt>24574180</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>16757682</BOYAmt>
        <EOYAmt>35269328</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>174632326</BOYAmt>
        <EOYAmt>197572761</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>40476481</BOYAmt>
        <EOYAmt>29762283</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>40702</BOYAmt>
        <EOYAmt>405945</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>647659</BOYAmt>
        <EOYAmt>319177</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>17849114</BOYAmt>
        <EOYAmt>17163414</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>8011441</BOYAmt>
        <EOYAmt>27423788</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>67025397</BOYAmt>
        <EOYAmt>75074607</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>107606929</BOYAmt>
        <EOYAmt>122498154</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>107606929</BOYAmt>
        <EOYAmt>122498154</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>174632326</BOYAmt>
        <EOYAmt>197572761</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>17724535</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-4147060</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>1313750</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolAndSepBasisFinclStmtInd>X</ConsolAndSepBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc10">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>18516168</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>20390637</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27411060</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>35627208</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>30601452</CurrentTaxYearAmt>
        <TotalAmt>132546525</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>18516168</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>20390637</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27411060</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>35627208</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>30601452</CurrentTaxYearAmt>
        <TotalAmt>132546525</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>132546525</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>238030</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>558943</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>505825</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>551814</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1156128</CurrentTaxYearAmt>
        <TotalAmt>3010740</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>3395225</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5185306</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10786091</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>19366622</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>154923887</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>848816223</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.85560</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.82850</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART II, LINE 10</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME FOR YEARS 2016-2020 19,366,622</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <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="RetDoc4">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>4956588</OtherCostOrOtherBasisAmt>
        <BookValueAmt>4956588</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>57709191</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>30827292</DepreciationAmt>
        <BookValueAmt>26881899</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>52434238</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>28009499</DepreciationAmt>
        <BookValueAmt>24424739</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>56263226</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>DUE FROM RELATED PARTIES</Desc>
        <BookValueAmt>19603419</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>ASSETS LIMITED AS TO USE</Desc>
        <BookValueAmt>12000000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>ROU ASSET</Desc>
        <BookValueAmt>3665909</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>35269328</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO OTHER FUNDS</Desc>
        <Amt>18741724</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>CONTINGENCY AND RISK POOL RESERVES</Desc>
        <Amt>4000000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITY</Desc>
        <Amt>3691307</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER MISC LIABILITIES</Desc>
        <Amt>990757</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>27423788</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>248595302</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-4147060</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-4147060</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>252742362</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>252742362</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>235017827</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>235017827</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>235017827</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc5">
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <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>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NANCY JOHNSON</PersonNm>
        <TitleTxt>INTERIM CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>533105</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>44748</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>577853</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DOUGLAS SPEGMAN</PersonNm>
        <TitleTxt>CCO</TitleTxt>
        <BaseCompensationFilingOrgAmt>385327</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>54074</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>439401</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RAJIV MODAK</PersonNm>
        <TitleTxt>CQO</TitleTxt>
        <BaseCompensationFilingOrgAmt>321857</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>36392</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>358249</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GREGORY RAGLOW</PersonNm>
        <TitleTxt>CMIO</TitleTxt>
        <BaseCompensationFilingOrgAmt>316089</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>46167</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>362256</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOSHUA CARZOLI</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>285478</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>43514</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>328992</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ZIAD HEMZAWI</PersonNm>
        <TitleTxt>PEDIATRICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>429174</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>45900</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>475074</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANDREW ARTHUR</PersonNm>
        <TitleTxt>PEDIATRICS MED DIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>422998</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>46886</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>469884</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LISA SOLTANI</PersonNm>
        <TitleTxt>INTERNAL MED DIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>415725</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>42233</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>457958</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOY MOCKBEE</PersonNm>
        <TitleTxt>FAMILY PRACTICE DIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>349276</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>43797</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>393073</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>FELIPE PEREZ</PersonNm>
        <TitleTxt>PROFESSIONS EDU DIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>331085</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>42619</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>373704</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc6">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COMPASS NOTE-EL PUEBLO</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>860445981</BondIssuerEIN>
        <BondIssuedDt>2010-06-01</BondIssuedDt>
        <IssuePriceAmt>4000000</IssuePriceAmt>
        <PurposeDesc>DEVELOPMENT OF MEDICAL FACILITIES AND TO PAY THE COST OF ISSUANCE.</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>false</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>false</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PURPOSE OF ISSUE DESCRIPTION</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPASS NOTE-EL PUEBLO DEVELOPMENT OF MEDICAL FACILITIES AND TO PAY THE COST OF ISSUANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="RetDoc7">
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>3861602</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc8">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990 WILL BE REVIEWED BY THE CEO AND CFO, THEN BY THE BUDGET &amp; FINANCE COMMITTEE MEMBERS EITHER AT A BOARD MEETING, TIME PERMITTING, OR VIA EMAIL IF TIME DOES NOT ALLOW IT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>IN MATTERS RELATED TO BOARD MEMBERS, REVIEW AND FOLLOW-UP WILL BE THE RESPONSIBILITY OF THE BOARD PRESIDENT; IN MATTERS RELATED TO THE MEDICAL STAFF AND EMPLOYEES, REVIEW AND FOLLOW-UP WILL BE THE RESPONSIBILITY OF THE CEO. IF REVIEW / INVESTIGATION SHOULD DISCOVER: -REASONABLE CAUSE TO BELIEVE THAT AN INDIVIDUAL HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST; THEY SHALL INFORM THE INDIVIDUAL OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INDIVIDUAL AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. -IF, AFTER HEARING THE RESPONSE OF THE INDIVIDUAL AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, A DETERMINATION SHALL BE MADE THAT THE INDIVIDUAL HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION SHALL BE TAKEN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR DETERMINING THE COMPENSATION OF THE KEY EMPLOYEES INCLUDED A REVIEW AND APPROVAL BASED ON A COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, AND COMPENSATION SURVEY/STUDY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>1) A REASONABLE RANGE OF COMPENSATION AND BENEFITS PACKAGES, FOR EACH POSITION, IS DETERMINED BY AN INDEPENDENT AND CERTIFIED COMPENSATION/BENEFITS CONSULTANT, 2) CONSULTANT ESTABLISHES THE RANGES OF SALARIES AND BENEFITS BY USING RECOGNIZED SURVEYS FROM ORGANIZATIONS THAT ARE COMPARABLE TO EL RIO IN SIZE, GEOGRAPHIC AREA AND SERVICES THAT ARE PROVIDED, 3) ALL SURVEY DATA IS REDUCED TO A WRITTEN REPORT THAT CONTAINS RECOMMENDATIONS BY THE INDEPENDENT CONSULTANT, AND 4) THE INDEPENDENT CONSULTANT THEN PRESENTS THE DATA AND RECOMMENDATIONS TO THE EL RIO BOARD OF DIRECTORS FOR A FORMAL VOTE WHICH IS THEN DOCUMENTED IN THE BOARD MINUTES. ONLY "DISINTERESTED" PARTIES, AS DEFINED BY THE CODE, ARE ALLOWED TO PARTICIPATE IN THE DECISION MAKING PROCESS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE IN ADMINISTRATION: 450 W. PASEO REDONDO, TUCSON, AZ 85701.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN FAIR VALUE INT RATE SWAP 1,313,750 JOINT VENTURE - HEALTH ON TUCSON 0 TOTAL 1,313,750</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc9">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HEALTH ON TUCSON LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 WEST BROADWAY BLVD</AddressLine1Txt>
          <CityNm>TUCSON</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>85701</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AZ</LegalDomicileStateCd>
        <TotalIncomeAmt>18171037</TotalIncomeAmt>
        <EndOfYearAssetsAmt>-1380841</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>EL RIO</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIMA COMMUNITY ACCESS PROGRAM INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>450 W PASEO REDONDO</AddressLine1Txt>
          <CityNm>TUCSON</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>85701</ZIPCd>
        </USAddress>
        <EIN>861014012</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AZ</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>EL RIO FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>450 W PASEO REDONDO</AddressLine1Txt>
          <CityNm>TUCSON</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>85701</ZIPCd>
        </USAddress>
        <EIN>860816675</EIN>
        <PrimaryActivitiesTxt>FOUNDATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AZ</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SOUTHEAST HOLDINGS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1231</AddressLine1Txt>
          <CityNm>TUCSON</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>85702</ZIPCd>
        </USAddress>
        <EIN>832153632</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AZ</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHERRYBELL HOLDINGS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1231</AddressLine1Txt>
          <CityNm>TUCSON</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>85702</ZIPCd>
        </USAddress>
        <EIN>831644508</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AZ</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>GRANT ROAD HOLDINGS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1231</AddressLine1Txt>
          <CityNm>TUCSON</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>85702</ZIPCd>
        </USAddress>
        <EIN>863455405</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AZ</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>GRANT ROAD HOLDINGS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>96948</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>CHERRYBELL HOLDINGS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>124352</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SOUTHEAST HOLDINGS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>105000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
