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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DI WU</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JABERPREET SINGH</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN CONNER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3439168</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>185847</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>203</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>OCHIN INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 5426</AddressLine1Txt>
            <CityNm>PORTLAND</CityNm>
            <StateAbbreviationCd>OR</StateAbbreviationCd>
            <ZIPCd>97228</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EHR SERVICES</ServicesDesc>
        <CompensationAmt>4642787</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PSYCHIATRIC MEDICAL</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1707 EYE ST SUITE 100</AddressLine1Txt>
            <CityNm>BAKERSFIELD</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93301</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MENTAL HEALTH</ServicesDesc>
        <CompensationAmt>4142900</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ECO-FRIENDLY CC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 13451</AddressLine1Txt>
            <CityNm>BAKERSFIELD</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93389</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>JANITORIAL SER.</ServicesDesc>
        <CompensationAmt>3774420</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>LANGUAGE LINE SERVICES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 202564</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75320</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LANGUAGE SVS</ServicesDesc>
        <CompensationAmt>2411002</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>M&amp;S SECURITY SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2900 L ST</AddressLine1Txt>
            <CityNm>BAKERSFIELD</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93301</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SECURITY SVS</ServicesDesc>
        <CompensationAmt>2263749</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>92</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>69109638</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>2288209</AllOtherContributionsAmt>
      <TotalContributionsAmt>71397847</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>146931051</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>146931051</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>INCENTIVE REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>4512118</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4512118</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>151443169</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>276690</TotalRevenueColumnAmt>
        <ExclusionAmt>276690</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>43020</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>29079</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>13941</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>13941</TotalRevenueColumnAmt>
        <ExclusionAmt>13941</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2861833</SecuritiesAmt>
        <OtherAmt>500</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>2764437</SecuritiesAmt>
        <OtherAmt>122395</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>97396</SecuritiesAmt>
        <OtherAmt>-121895</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-24499</TotalRevenueColumnAmt>
        <ExclusionAmt>-24499</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>199708</TotalRevenueColumnAmt>
        <ExclusionAmt>199708</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>199708</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>223306856</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>151443169</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>465840</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>872786</TotalAmt>
        <ManagementAndGeneralAmt>872786</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>115150999</TotalAmt>
        <ProgramServicesAmt>93671520</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21479479</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>3539695</TotalAmt>
        <ProgramServicesAmt>3515348</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24347</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>14183008</TotalAmt>
        <ProgramServicesAmt>13153990</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1029018</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>10559731</TotalAmt>
        <ProgramServicesAmt>7782610</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2777121</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>985061</TotalAmt>
        <ManagementAndGeneralAmt>985061</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>295946</TotalAmt>
        <ManagementAndGeneralAmt>295946</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>42847</TotalAmt>
        <ManagementAndGeneralAmt>42847</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>30206129</TotalAmt>
        <ProgramServicesAmt>24108450</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6097679</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>1049212</TotalAmt>
        <ProgramServicesAmt>226553</ProgramServicesAmt>
        <ManagementAndGeneralAmt>822659</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>5336811</TotalAmt>
        <ProgramServicesAmt>2679738</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2657073</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>1820226</TotalAmt>
        <ProgramServicesAmt>557898</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1262328</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>8320116</TotalAmt>
        <ProgramServicesAmt>7281497</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1038619</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>801889</TotalAmt>
        <ProgramServicesAmt>467674</ProgramServicesAmt>
        <ManagementAndGeneralAmt>334215</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>943211</TotalAmt>
        <ProgramServicesAmt>470080</ProgramServicesAmt>
        <ManagementAndGeneralAmt>473131</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>374796</TotalAmt>
        <ProgramServicesAmt>253408</ProgramServicesAmt>
        <ManagementAndGeneralAmt>121388</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>4802968</TotalAmt>
        <ProgramServicesAmt>1115225</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3687743</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>847285</TotalAmt>
        <ManagementAndGeneralAmt>847285</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES &amp; DRUGS</Desc>
        <TotalAmt>16089834</TotalAmt>
        <ProgramServicesAmt>16089834</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>2450355</TotalAmt>
        <ProgramServicesAmt>833463</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1616892</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PATIENT &amp; CLIENT SERVICES</Desc>
        <TotalAmt>641701</TotalAmt>
        <ProgramServicesAmt>393443</ProgramServicesAmt>
        <ManagementAndGeneralAmt>248258</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>7060946</TotalAmt>
        <ProgramServicesAmt>4145739</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2915207</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>226375552</TotalAmt>
        <ProgramServicesAmt>176746470</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49629082</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>18723540</BOYAmt>
        <EOYAmt>1976679</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>4306503</BOYAmt>
        <EOYAmt>1311375</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>7202553</BOYAmt>
        <EOYAmt>6628180</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>10891486</BOYAmt>
        <EOYAmt>14873388</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>2686260</BOYAmt>
        <EOYAmt>2115990</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>228418</BOYAmt>
        <EOYAmt>228418</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1308116</BOYAmt>
        <EOYAmt>1324856</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>85585132</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>35138414</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>52237871</BOYAmt>
        <EOYAmt>50446718</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>8381014</BOYAmt>
        <EOYAmt>9284534</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>39466726</BOYAmt>
        <EOYAmt>55697172</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>145432487</BOYAmt>
        <EOYAmt>143887310</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>20222654</BOYAmt>
        <EOYAmt>35166848</EOYAmt>
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      <DeferredRevenueGrp>
        <BOYAmt>1271702</BOYAmt>
        <EOYAmt>3690605</EOYAmt>
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      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>27778</BOYAmt>
        <EOYAmt>19445</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>56175767</BOYAmt>
        <EOYAmt>40024726</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>77697901</BOYAmt>
        <EOYAmt>78901624</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>67568586</BOYAmt>
        <EOYAmt>64715391</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>166000</BOYAmt>
        <EOYAmt>270295</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>67734586</BOYAmt>
        <EOYAmt>64985686</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>145432487</BOYAmt>
        <EOYAmt>143887310</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-3068696</ReconcilationRevenueExpnssAmt>
      <PriorPeriodAdjustmentsAmt>319796</PriorPeriodAdjustmentsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleA documentId="RetDoc6">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>60080313</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>66793750</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>74949772</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>74097338</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>71397847</CurrentTaxYearAmt>
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      <TotalCalendarYear170Grp>
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        <CurrentTaxYearMinus1YearAmt>74097338</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>71397847</CurrentTaxYearAmt>
        <TotalAmt>347319020</TotalAmt>
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      <PublicSupportTotal170Amt>347319020</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>1678560</CurrentTaxYearMinus4YearsAmt>
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        <CurrentTaxYearMinus2YearsAmt>816886</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>774857</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>319710</CurrentTaxYearAmt>
        <TotalAmt>4719715</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus1YearAmt>54954</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>199708</CurrentTaxYearAmt>
        <TotalAmt>254662</TotalAmt>
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      <TotalSupportAmt>352293397</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>502713643</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.98590</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.98230</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART II, LINE 10</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICAL RECORDS 1,257 OTHER 253,405</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
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    <IRS990ScheduleB documentId="RetDoc1">
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        <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="RetDoc3">
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        <BookValueAmt>4276690</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>55168260</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>23052662</DepreciationAmt>
        <BookValueAmt>32115598</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
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        <DepreciationAmt>1517617</DepreciationAmt>
        <BookValueAmt>6431799</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>15550454</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>10568135</DepreciationAmt>
        <BookValueAmt>4982319</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>2640312</OtherCostOrOtherBasisAmt>
        <BookValueAmt>2640312</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>50446718</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>OPERATING LEASE RIGHT-OF-USE ASSETS</Desc>
        <BookValueAmt>39617585</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>ESTIMATED THIRD-PARTY RECEIVABLE</Desc>
        <BookValueAmt>12854585</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>EMPLOYEE RETENTION CREDIT RECEIVABLE</Desc>
        <BookValueAmt>3103126</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OTHER RECEIVABLES</Desc>
        <BookValueAmt>121876</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>55697172</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>OPERATING LEASE LIABILITY</Desc>
        <Amt>40024726</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>40024726</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>223293088</TotalRevEtcAuditedFinclStmtAmt>
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        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE ORGANIZATION EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF MARCH 31, 2024 AND 2023, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSE 29,079</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XII, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSE 29,079</ExplanationTxt>
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        <PersonNm>RAMNEET KAUR MANGAT</PersonNm>
        <TitleTxt>DIR. WOMEN'S HEALTH</TitleTxt>
        <BaseCompensationFilingOrgAmt>439862</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>31500</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>90999</OtherCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AUTHER ADAMS</PersonNm>
        <TitleTxt>PHYSICIAN OB/GYN</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TINA DHILLON-ASHLEY</PersonNm>
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        <PersonNm>RYAN JOHNSON</PersonNm>
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        <PersonNm>EMAD HASHEMI</PersonNm>
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        <PersonNm>OLGA MEAVE</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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        <BonusFilingOrganizationAmount>1500</BonusFilingOrganizationAmount>
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        <PersonNm>JOHN CHURCH</PersonNm>
        <TitleTxt>INTERIM CFO</TitleTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION'S MISSION: IT SHALL BE THE MISSION OF CLINICA SIERRA VISTA TO PROVIDE HIGH QUALITY AND COMPREHENSIVE PRIMARY AND PREVENTATIVE HEALTH CARE SERVICES AS THE MOST EFFICIENT COST TO UNDERSERVED POPULATIONS OF KERN AND FRESNO COUNTIES REGARDLESS OF ABILITY TO PAY AND TO SEEK NECESSARY RESOURCES TO MEET THE GROWING HEALTH CARE DEMANDS WHILE MAINTAINING THE CORPORATION'S FINANCIAL INTEGRITY. WE STRONGLY BELIEVE IN EVERYONE'S RIGHT TO QUALITY HEALTH CARE. THEREFORE, NO ONE IS DENIED SERVICES BASED ON RACE, RELIGION, ETHNICITY, SEX, AGE, DISABILITY OR ECONOMIC STATUS. LINE 4B BEHAVIORAL AND MENTAL HEALTH SERVICES: IN ADDITION, SEVERAL COMMUNITY HEALTH CENTERS THROUGHOUT BOTH COUNTIES ARE STAFFED WITH INTEGRATED SOCIAL WORK TO PROVIDE LIGHT THERAPY AND OTHER SOCIAL WORK SERVICES TO OUR PATIENTS. WE CAN ALSO BE FOUND ON MANY SCHOOL CAMPUSES. IN BOTH COUNTIES, OUR SPECIALTY BEHAVIORAL HEALTH CENTERS OFFER SPECIFIC TEAMS FOR CHILDREN (AGES 3-18) AND ADULTS (AGES 18+) WITH MENTAL/BEHAVIORAL HEALTH AND/OR SUBSTANCE USE PROBLEMS. ALL SERVICES ARE PROVIDED IN THE CLIENT'S PREFERRED LANGUAGE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>CLINICA SIERRA VISTA PROVIDES NUTRITION EDUCATION AND SUPPLEMENTAL FOODS TO SAFEGUARD THE HEALTH OF LOW-INCOME PREGNANT, BREASTFEEDING, AND POSTPARTUM WOMEN, AS WELL AS INFANTS AND CHILDREN. THIS PROGRAM IS FUNDED PRIMARILY THROUGH THE SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN (WIC).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>A COPY OF THE 990 IS REVIEWED BY THE CFO. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PROVIDED TO THE BOARD OF DIRECTORS. ONCE THE BOARD AND MANAGEMENT ARE SATISFIED WITH THE 990, THE CFO SIGNS THE FORM 8879-TE AUTHORIZING THE PREPARER TO E-FILE THE RETURN</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CLINICA SIERRA VISTA HAS A CONFLICT OF INTEREST POLICY AND EMPLOYEE CONDUCT IN THE EMPLOYEE HANDBOOK. EACH EMPLOYEE IS GIVEN THE HANDBOOK, AND THIS POLICY IS ALSO REVIEWED WITH EACH NEW HIRE. OUR POLICY REQUIRES EMPLOYEES TO REQUEST APPROVAL FOR OUTSIDE EMPLOYMENT. IT REQUIRES DISCLOSURE OF POTENTIAL PERSONAL AND PROFESSIONAL CONFLICTS AND PROHIBITS EMPLOYEES FROM ENGAGING IN BUSINESS TRANSACTIONS THAT RESULT IN PERSONAL GAIN. THE HUMAN RESOURCES DEPARTMENT AND SUPERVISORS MONITOR ADHERENCE TO THIS POLICY. THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ANY CONFLICT OF INTEREST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR THE CEO IS DETERMINED AND APPROVED BY CSV'S BOARD OF DIRECTORS. THE CEO DETERMINES AND APPROVES COMPENSATION FOR OFFICERS AND KEY EMPLOYEES BASED ON THE BOARD-APPROVED SALARY SCHEDULE AND INDIVIDUALS' QUALIFICATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE FORM 990, PART VI, LINE 15A.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND FORM 990 ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER PROFESSIONAL FEES 6,149,095 5,205,470 0 CUSTODIAL SERVICES 3,329,293 517,252 0 INTERPRETING SERVICES 2,333,543 99,357 0 PHARMACY SERVICES 2,980,376 0 0 PHYSICIAN FEES 2,059,921 0 0 PSYCHIATRIST FEES 4,296,006 31,970 0 SECURITY 2,960,216 243,630 0 TOTAL 24,108,450 6,097,679 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSE 29,079 RENTAL EXPENSE -29,079</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT FOR THE FISCAL YEAR ENDED MARCH 31, 2024 IS CURRENTLY IN PROCESS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>