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        <TitleTxt>Vice President</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Fabiola Rivera</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Marisol Marquina</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Christopher Cruz</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lisa Misraje</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3053344</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>322011</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>147</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>ScribeAmerica</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 417756</AddressLine1Txt>
            <CityNm>Boston</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02241</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Scribe services</ServicesDesc>
        <CompensationAmt>305726</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>THFF REIT</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3000 Olympic Blvd</AddressLine1Txt>
            <CityNm>Santa Monica</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>90404</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Occupancy</ServicesDesc>
        <CompensationAmt>646508</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Skywriter MD</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1716 Briarcrest Drive</AddressLine1Txt>
            <AddressLine2Txt>Suite 200</AddressLine2Txt>
            <CityNm>Bryan</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>77802</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Scribe Services</ServicesDesc>
        <CompensationAmt>271552</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Mission Medical Temecula</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>9070 Irvine Center Drive</AddressLine1Txt>
            <CityNm>Irvine</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92618</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Occupancy</ServicesDesc>
        <CompensationAmt>217556</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Smiles of Temecula Dental</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>27365 Jefferson Avenue</AddressLine1Txt>
            <CityNm>Temecula</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92590</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contracted Dental</ServicesDesc>
        <CompensationAmt>269620</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>13</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>242669</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>17831122</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>29295</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>18103086</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Net patient service revenue</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>111437797</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>111437797</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>17390044</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>17390044</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>128827841</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1861061</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1861061</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>394017</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>104279</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>289738</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>289738</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>289738</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <ContriRptFundraisingEventAmt>242669</ContriRptFundraisingEventAmt>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>149081726</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>128827841</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>289738</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1861061</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>67213483</TotalAmt>
        <ProgramServicesAmt>47682417</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19283267</ManagementAndGeneralAmt>
        <FundraisingAmt>247799</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>12559859</TotalAmt>
        <ProgramServicesAmt>8742734</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3769060</ManagementAndGeneralAmt>
        <FundraisingAmt>48065</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>14890101</TotalAmt>
        <ProgramServicesAmt>12898561</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1976942</ManagementAndGeneralAmt>
        <FundraisingAmt>14598</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>5704754</TotalAmt>
        <ProgramServicesAmt>5513489</ProgramServicesAmt>
        <ManagementAndGeneralAmt>182957</ManagementAndGeneralAmt>
        <FundraisingAmt>8308</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>1167546</TotalAmt>
        <ProgramServicesAmt>630129</ProgramServicesAmt>
        <ManagementAndGeneralAmt>536657</ManagementAndGeneralAmt>
        <FundraisingAmt>760</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>5344083</TotalAmt>
        <ProgramServicesAmt>4123629</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1205960</ManagementAndGeneralAmt>
        <FundraisingAmt>14494</FundraisingAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>410357</TotalAmt>
        <ProgramServicesAmt>170985</ProgramServicesAmt>
        <ManagementAndGeneralAmt>235270</ManagementAndGeneralAmt>
        <FundraisingAmt>4102</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>328814</TotalAmt>
        <ProgramServicesAmt>231676</ProgramServicesAmt>
        <ManagementAndGeneralAmt>97138</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1754002</TotalAmt>
        <ProgramServicesAmt>1513169</ProgramServicesAmt>
        <ManagementAndGeneralAmt>240833</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>619669</TotalAmt>
        <ProgramServicesAmt>411634</ProgramServicesAmt>
        <ManagementAndGeneralAmt>207968</ManagementAndGeneralAmt>
        <FundraisingAmt>67</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Equipment costs</Desc>
        <TotalAmt>5506588</TotalAmt>
        <ProgramServicesAmt>2599918</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2879994</ManagementAndGeneralAmt>
        <FundraisingAmt>26676</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Realized loss on investments</Desc>
        <TotalAmt>2850118</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2850118</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>2496921</TotalAmt>
        <ProgramServicesAmt>1390661</ProgramServicesAmt>
        <ManagementAndGeneralAmt>980803</ManagementAndGeneralAmt>
        <FundraisingAmt>125457</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>120846295</TotalAmt>
        <ProgramServicesAmt>85909002</ProgramServicesAmt>
        <ManagementAndGeneralAmt>34446967</ManagementAndGeneralAmt>
        <FundraisingAmt>490326</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>13506767</BOYAmt>
        <EOYAmt>22048686</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>40917531</BOYAmt>
        <EOYAmt>73758</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>2450643</BOYAmt>
        <EOYAmt>3595824</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>9931690</BOYAmt>
        <EOYAmt>9691735</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
        <BOYAmt>6021</BOYAmt>
        <EOYAmt>5263</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>2408457</BOYAmt>
        <EOYAmt>2912425</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>52861455</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>13793465</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>27239803</BOYAmt>
        <EOYAmt>39067990</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
        <EOYAmt>51097339</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>8944357</BOYAmt>
        <EOYAmt>15409603</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>105405269</BOYAmt>
        <EOYAmt>143902623</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>10892937</BOYAmt>
        <EOYAmt>12986091</EOYAmt>
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      <DeferredRevenueGrp>
        <BOYAmt>272833</BOYAmt>
        <EOYAmt>1167035</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>6321559</BOYAmt>
        <EOYAmt>16178214</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>43199</BOYAmt>
        <EOYAmt>260993</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>17530528</BOYAmt>
        <EOYAmt>30592333</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>87524237</BOYAmt>
        <EOYAmt>113148220</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>350504</BOYAmt>
        <EOYAmt>162070</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>87874741</BOYAmt>
        <EOYAmt>113310290</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>105405269</BOYAmt>
        <EOYAmt>143902623</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>28235431</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-2799882</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>0</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="R000002" softwareId="21013178" softwareVersionNum="v1.00">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>10073046</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9662214</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10930309</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16954655</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>19089996</CurrentTaxYearAmt>
        <TotalAmt>66710220</TotalAmt>
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      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>10073046</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9662214</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10930309</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16954655</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>19089996</CurrentTaxYearAmt>
        <TotalAmt>66710220</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>66710220</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>544680</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>348258</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>681537</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>606478</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2150799</CurrentTaxYearAmt>
        <TotalAmt>4331752</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>71041972</TotalSupportAmt>
      <PublicSupportCY170Pct>0.93903</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.95785</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="R000003" softwareId="21013178" softwareVersionNum="v1.00">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <BookValueAmt>0</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>46793409</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>12124775</DepreciationAmt>
        <BookValueAmt>34668634</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>3127817</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1668690</DepreciationAmt>
        <BookValueAmt>1459127</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>2940229</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>2940229</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>39067990</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Estimated third party settlements</Desc>
        <BookValueAmt>15409603</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>15409603</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated third party settlements</Desc>
        <Amt>260993</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>260993</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>149081726</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>0</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <RecoveriesPriorYearGrantsAmt>0</RecoveriesPriorYearGrantsAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>149081726</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>0</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>149081726</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>120846295</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>0</DonatedServicesUseFcltsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Discussion of the annual organization's achievements occurs during the monthly board meeting after the 990 is finalized. The finance committee, which is made up of a combination of board members and members of the community receives a copy of the 990 form before it is filed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>A Compliance Officer is identified and compliance is on the agenda for several board meetings throughout the year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The board reviews the compensation of key employees annually. A market analysis of salaries is completed and shared with the board as well. In addition, an outside firm may be brought in to further analyze the compensation of key employees. The full board reviews and approves the compensation of the CEO based on this data during a closed session. Minutes are kept on file.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Professional and Purchased Services.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>