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        <ReportableCompFromOrgAmt>244526</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10766</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AJIT ARORA MD</PersonNm>
        <TitleTxt>BOARD MEMBER THRU 07/21</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>117230</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RONALD BIERMA MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>3000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROGER LARSEN</PersonNm>
        <TitleTxt>SVP, CORPORATE CFO AS OF 06/21</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>55.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FARID ASSEMI</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINZIE DANIEL</PersonNm>
        <TitleTxt>PAST CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROGER STURDEVANT</PersonNm>
        <TitleTxt>CHAIR ELECT</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN ABUNDIS</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEITH BOONE MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERRANCE BRADLEY EDD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JERRY COOK</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREG ESTEP</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WAGIH IBRAHIM MD</PersonNm>
        <TitleTxt>BOARD MEMBER AS OF 01/20</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>REN IMAI MD</PersonNm>
        <TitleTxt>BOARD MEMBER THRU 12/20</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH JONES PHD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAREN MCCAFFREY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN MCGREGOR</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RUTHIE QUINTO</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHANDRASEKAR VENUGOPAL MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.70</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>14032550</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>1341327</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>269</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PHYSICIAN NETWORK ADVANTAGE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>7255 N FIRST ST STE 103</AddressLine1Txt>
            <CityNm>FRESNO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93720</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TECHNOLOGY</ServicesDesc>
        <CompensationAmt>6552097</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CDW GOVERNMENT CDW-G</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>75 REMITTANCE DRIVE STE 1515</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606751515</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TECHNOLOGY</ServicesDesc>
        <CompensationAmt>5003133</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>EPIC SYSTEMS CORPORATION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1979 MILKY WAY</AddressLine1Txt>
            <CityNm>VERONA</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53593</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TECHNOLOGY</ServicesDesc>
        <CompensationAmt>4428014</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JONES DAY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>555 SOUTH FLOWER ST 50TH FLR</AddressLine1Txt>
            <CityNm>LOS ANGELES</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>90071</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LEGAL SERVICES</ServicesDesc>
        <CompensationAmt>4249771</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AMN HEALTHCARE INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>BANK OF AMERICA 450 B ST STE 1500</AddressLine1Txt>
            <CityNm>SAN DIEGO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92101</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>STAFFING SERVICES</ServicesDesc>
        <CompensationAmt>4120114</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>149</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>228278</RelatedOrganizationsAmt>
      <TotalContributionsAmt>228278</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT FEES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>222975624</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>222975624</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PROGRAM SERVICE RENTAL</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>751058</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>751058</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>APPLICATION REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>242251</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>242251</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SPECIAL SERVICES REVEN</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>157080</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>157080</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>GAIN FROM SANTE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>3604</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3604</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>3684406</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3684406</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>227814023</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>48351</TotalRevenueColumnAmt>
        <ExclusionAmt>48351</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>8420955</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>7181743</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>1239212</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>1239212</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>83913</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1155299</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>122765</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>66020</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>56745</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>56745</TotalRevenueColumnAmt>
        <ExclusionAmt>56745</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>CHANGE IN PENSION</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>10816166</TotalRevenueColumnAmt>
        <ExclusionAmt>10816166</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>10816166</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>240202775</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>227814023</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>83913</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>12076561</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>301000</TotalAmt>
        <ProgramServicesAmt>301000</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>694504</TotalAmt>
        <ManagementAndGeneralAmt>694504</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>167344</TotalAmt>
        <ManagementAndGeneralAmt>167344</ManagementAndGeneralAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>114692010</TotalAmt>
        <ProgramServicesAmt>96341288</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18350722</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>3156694</TotalAmt>
        <ProgramServicesAmt>2651623</ProgramServicesAmt>
        <ManagementAndGeneralAmt>505071</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>14624100</TotalAmt>
        <ProgramServicesAmt>12284244</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2339856</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>7443208</TotalAmt>
        <ProgramServicesAmt>6252295</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1190913</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>4900850</TotalAmt>
        <ManagementAndGeneralAmt>4900850</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>141294</TotalAmt>
        <ManagementAndGeneralAmt>141294</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>572540</TotalAmt>
        <ManagementAndGeneralAmt>572540</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>26867185</TotalAmt>
        <ProgramServicesAmt>11550091</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15317094</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>3871038</TotalAmt>
        <ProgramServicesAmt>3871038</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>10166771</TotalAmt>
        <ProgramServicesAmt>7320075</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2846696</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>27476049</TotalAmt>
        <ProgramServicesAmt>27476049</ProgramServicesAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>3725727</TotalAmt>
        <ProgramServicesAmt>3129611</ProgramServicesAmt>
        <ManagementAndGeneralAmt>596116</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>101118</TotalAmt>
        <ProgramServicesAmt>101118</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>72111</TotalAmt>
        <ProgramServicesAmt>72111</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>280322</TotalAmt>
        <ProgramServicesAmt>280322</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>16277395</TotalAmt>
        <ProgramServicesAmt>13673012</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2604383</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>2431430</TotalAmt>
        <ProgramServicesAmt>2371430</ProgramServicesAmt>
        <ManagementAndGeneralAmt>60000</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>OTHER OPERATING EXPENSE</Desc>
        <TotalAmt>1382392</TotalAmt>
        <ProgramServicesAmt>149938</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1232454</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>UBI TAXES</Desc>
        <TotalAmt>1082516</TotalAmt>
        <ProgramServicesAmt>1082516</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>883749</TotalAmt>
        <ProgramServicesAmt>441874</ProgramServicesAmt>
        <ManagementAndGeneralAmt>441875</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LEASE AND RENTAL PAYMEN</Desc>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>189565960</ProgramServicesAmt>
        <ManagementAndGeneralAmt>52178037</ManagementAndGeneralAmt>
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        <EOYAmt>550133</EOYAmt>
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        <EOYAmt>8765903</EOYAmt>
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        <EOYAmt>129161455</EOYAmt>
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        <EOYAmt>10225960</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>153264006</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>266645</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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      <MortgNotesPyblScrdInvstPropGrp>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>229728601</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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        <EOYAmt>-76464595</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>-103955373</BOYAmt>
        <EOYAmt>-76464595</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>153264006</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1541222</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>29032000</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <SupportingOrgType2Ind>X</SupportingOrgType2Ind>
      <SupportedOrganizationsCnt>1</SupportedOrganizationsCnt>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>FRESNO COMMUNITY HOSPITAL &amp; MEDICAL CENTER</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>941156276</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>0</GoverningDocumentListedInd>
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        <OtherSupportAmt>0</OtherSupportAmt>
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      <SupportedOrganizationsTotalCnt>1</SupportedOrganizationsTotalCnt>
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        <Contribution35ControlledInd>0</Contribution35ControlledInd>
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      <MajorityDirTrstSupportedOrgInd>1</MajorityDirTrstSupportedOrgInd>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART IV, SECTION A, LINE 6:</FormAndLineReferenceDesc>
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        <ContributorBusinessName>
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        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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      <DirectContactLegislatorsInd>1</DirectContactLegislatorsInd>
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      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>0</OtherActivitiesInd>
      <TotalLobbyingExpendituresAmt>572540</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHCC MAINTAINS A GOVERNMENT RELATIONS FUNCTION TO MONITOR PENDING LEGISLATION AND TO INFLUENCE LEGISLATORS AND PUBLIC OPINION ON HEALTH CARE ISSUES. PAYMENTS MADE TO LOBBYISTS ARE DISCLOSED BELOW. THE FORHAN COMPANY: PROFESSIONAL FEES WERE PAID FOR FEDERAL, STATE OF CALIFORNIA, COUNTY OF FRESNO AND CITY OF FRESNO FOR GOVERNMENT RELATIONS AND ADVOCACY SERVICES. CJ LAKE: PROFESSIONAL FEES WERE PAID FOR FEDERAL GOVERNMENT RELATIONS AND ADVOCACY SERVICES. PEACH: A PORTION OF DUES PAID DIRECTLY RELATE TO LOBBYING ACTIVITY. CALIFORNIA HOSPITAL COUNCIL: A PORTION OF DUES PAID DIRECTLY RELATE TO LOBBYING ACTIVITY. HOOPER, LUNDY, AND BOOKMAN, INC. AND VILLINES GROUP, LLP: FEES RELATE DIRECTLY TO LOBBYING/GOVERNMENTAL RELATIONS ACTIVITY.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, SCHEDULE D, PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE IS NO FOOTNOTE FOR FIN 48 IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DUE TO IMMATERIALITY.</ExplanationTxt>
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    </IRS990ScheduleC>
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        <OtherCostOrOtherBasisAmt>12601807</OtherCostOrOtherBasisAmt>
        <BookValueAmt>29477345</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
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        <DepreciationAmt>42484529</DepreciationAmt>
        <BookValueAmt>69351063</BookValueAmt>
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      <LeaseholdImprovementsGrp>
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        <DepreciationAmt>1736262</DepreciationAmt>
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          <CityNm>CLOVIS</CityNm>
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      <RecipientTable>
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      <RecipientTable>
        <RecipientBusinessName>
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          <CityNm>FRESNO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
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      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TIM JOSLIN - FORMER PRESIDENT</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER THRU 07/20</TitleTxt>
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        <CompReportPrior990FilingOrgAmt>92490</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOSEPH NOWICKI</PersonNm>
        <TitleTxt>SVP, CORPORATE CFO THRU 12/20</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CARLA MILTON</PersonNm>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>704258</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>47160</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES FRANKLIN</PersonNm>
        <TitleTxt>SVP, CHIEF INFORMATION OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>437512</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>124506</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>52878</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>17100</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13173</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>645169</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>43693</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRIANNE L MARRIOTT</PersonNm>
        <TitleTxt>SVP, CHIEF LEGAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>391878</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>150001</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>29221</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14250</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18021</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>603371</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DEBRA MUSCIO</PersonNm>
        <TitleTxt>SVP AUDIT AND COMPLIANCE THRU 07/21</TitleTxt>
        <BaseCompensationFilingOrgAmt>368119</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>74738</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14250</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12960</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>580435</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>40824</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JUDI BINDERMAN</PersonNm>
        <TitleTxt>VP CHIEF MEDICAL INFO OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>403360</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>75964</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>40188</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>17100</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13059</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>549671</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DEBORAH MOFFETT - VP FINANCE</PersonNm>
        <TitleTxt>INTERIM CFO/VICE FINANCIAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>331522</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>72572</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>7225</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>22800</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7625</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>441744</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHELLE VON TERSCH</PersonNm>
        <TitleTxt>SVP, COMMUN &amp; LEGIS AFFAIRS</TitleTxt>
        <BaseCompensationFilingOrgAmt>274682</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>106514</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>3037</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>22529</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>20320</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>427082</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BERJ APKARIAN - VPPHYSICIAN</PersonNm>
        <TitleTxt>INTERNATIONAL HEALTH RELATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>286555</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>53485</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>35547</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>22800</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7711</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>406098</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JUANITA HERNANDEZ - VICE</PersonNm>
        <TitleTxt>SECRETARY/DIRECTOR, CORP GOVERNANCE</TitleTxt>
        <BaseCompensationFilingOrgAmt>182399</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>38264</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>16208</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14226</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15251</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>266348</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBYNN L VAN PATTEN - FORMER</PersonNm>
        <TitleTxt>SVP, CHIEF LEGAL OFFICER THRU 06/19</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>244526</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10766</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>255292</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>FIRST-CLASS TRAVEL ON CERTAIN LONG-TERM OR OVERNIGHT FLIGHTS IS ALLOWED FOR THE CEO, COO, AND CFO. THIS IS NOT CONSIDERED TAXABLE TO THE EMPLOYEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINES 4A-B</FormAndLineReferenceDesc>
        <ExplanationTxt>LINE 4A: TIM JOSLIN AND THE ORGANIZATION ENTERED INTO A SEVERANCE AGREEMENT WHEREBY MR. JOSLIN WILL RECEIVE 52 BIWEEKLY PAYMENTS FOR $34,616 BEGINNING 07/18/2020 AND ENDING 07/02/2022. ROBYNN VAN PATTEN AND THE ORGANIZATION ENTERED INTO A SEVERANCE AGREEMENT WHEREBY MS. VAN PATTEN WILL RECEIVE 26 BIWEEKLY PAYMENTS FOR $17,505 BEGINNING 7/25/2019 AND ENDING 7/09/2020. LINE 4B: DURING THE YEAR, CONTRIBUTIONS WERE MADE TO THE SERP PLAN FOR THE FOLLOWING INDIVIDUAL: - CRAIG CASTRO $873,797 DURING THE YEAR, THE ORGANIZATION MADE THE FOLLOWING DISTRIBUTIONS FROM A SERP PLAN FOR THE FOLLOWING INDIVIDUALS: - CRAIG CASTRO $98,870 - ALDO DE LA TORRE $63,055 - JAMES FRANKLIN $43,693 - TIM JOSLIN $2,051,436 - CARLA MILTON $47,160 - DEBRA MUSCIO $40,824 - JOSEPH NOWICKI $67,152 - CRAIG WAGONER $92,490</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S EXECUTIVE INCENTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD KEY MEMBERS OF THE EXECUTIVE TEAM FOR MEETING SPECIFIC AND MEASURABLE GOALS AT THE COMMUNITY HEALTH SYSTEM (CHS) AND INDIVIDUAL LEVELS. THE MAIN OBJECTIVES ARE: - MOTIVATE EXECUTIVES AND REWARD THEM FOR IMPROVING CHS'S OPERATIONAL PERFORMANCE; - INCREASE COMMUNITY INVOLVEMENT AND EFFECTIVENESS; - INCREASE EXECUTIVE COMMITMENT TO CHS'S SHORT AND LONG TERM GOALS; - PROVIDE EXECUTIVES WITH COMPETITIVE BUT REASONABLE COMPENSATION; - AND ATTRACT AND RETAIN HIGHLY TALENTED EXECUTIVES THAT ARE CRITICALLY IMPORTANT TO THE SUCCESS OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE RESPONSE FOR QUESTION 5.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>KATHARINE MCGREGOR</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>FAMILY MEMBER OF JOHN MCGREGOR, A MEMBER OF CHCC'S BOARD OF TRUSTEES.</RelationshipDescriptionTxt>
        <TransactionAmt>60678</TransactionAmt>
        <TransactionDesc>EMPLOYMENT</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>SIMRUN ARORA</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>FAMILY MEMBER OF AJIT ARORA, MD, A MEMBER OF CHCC'S BOARD OF TRUSTEES.</RelationshipDescriptionTxt>
        <TransactionAmt>106666</TransactionAmt>
        <TransactionDesc>EMPLOYMENT</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>UPON COMPLETION OF AN INITIAL REVIEW BY SENIOR MANAGEMENT, THE FORM IS REVIEWED AT A MEETING OF THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE FINALIZED FORM 990 THEN BECOMES A RECORD OF THE ORGANIZATION'S BOARD OF TRUSTEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUALLY EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF COMMITTEE WITH BOARD DELEGATED POWERS SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER COMMITTEE WITH BOARD DELEGATED POWERS ALSO COMPLETES A CONFLICT OF INTEREST DISCLOSURE STATEMENT PRIOR TO THE ASSIGNMENT OF THEIR DUTIES AND THEREAFTER ON AN ANNUAL BASIS. THE STATEMENT ASKS SPECIFIC QUESTIONS THAT WOULD DETERMINE IF THERE ARE CONFLICTS OF INTERESTS. CHS'S CHIEF ETHICS &amp; COMPLIANCE OFFICER, AND CHIEF LEGAL OFFICER REVIEW THE RESPONSES AND DETERMINE WHETHER THERE IS A CONFLICT BASED ON POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE DIRECTOR, PRINCIPAL OFFICER, OR MEMBER COMMITTEE WITH BOARD DELEGATED POWERS WILL BE REMOVED FROM DECISION MAKING AS IT PERTAINS TO THAT CONFLICT. TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED. THE PERIODIC REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING; 2) WHETHER ARRANGEMENTS FOR PHYSICIAN AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; 3) WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; AND 4) WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION RESTS WITH THE BOARD'S EXECUTIVE COMPENSATION SUBCOMMITTEE. THE COMMITTEE WILL "CONSIDER ALL MATTERS INVOLVING COMPENSATION AND BENEFITS OF (I) CORPORATE OFFICERS WHO ARE CLASSIFIED AS "DISQUALIFIED PERSONS" PURSUANT TO INTERNAL REVENUE CODE SECTION 4958; (II) ALL OTHER CORPORATE OFFICERS WHO ARE SENIOR VICE PRESIDENTS AND EXECUTIVE VICE PRESIDENTS AND (III) THE PRESIDENT/CHIEF EXECUTIVE OFFICER." THROUGH THE EXECUTIVE COMPENSATION SUBCOMMITTEE, THE BOARD HAS ENGAGED SULLIVAN, COTTER AND ASSOCIATES, INC. TO CONDUCT A TOTAL COMPENSATION REVIEW FOR THOSE INDIVIDUALS IDENTIFIED IN THEIR SCOPE OF RESPONSIBILITY WHICH INCLUDED THE USE OF COMPARABILITY DATA AND DOCUMENTATION OF THE FINDINGS REPORTED TO THE COMMITTEE. THIS PROCESS WAS MOST RECENTLY COMPLETED IN OCTOBER, 2021.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>HBP FEES: PROGRAM SERVICE EXPENSES 13,083. MANAGEMENT AND GENERAL EXPENSES 17,342. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,425. MD SUPERVISORY FEES: PROGRAM SERVICE EXPENSES 490,317. MANAGEMENT AND GENERAL EXPENSES 649,955. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,140,272. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,786,136. MANAGEMENT AND GENERAL EXPENSES 2,367,667. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,153,803. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,711,398. MANAGEMENT AND GENERAL EXPENSES 11,554,179. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,265,577. COLLECTION AGENCIES: PROGRAM SERVICE EXPENSES 549,157. MANAGEMENT AND GENERAL EXPENSES 727,951. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,277,108.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN UNFUNDED ACCUMULATED PENSION BENEFIT OBLIGATION 29,032,000.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1560 E SHAW AVENUE</AddressLine1Txt>
          <CityNm>FRESNO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93710</ZIPCd>
        </USAddress>
        <EIN>941156276</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1560 E SHAW AVENUE</AddressLine1Txt>
          <CityNm>FRESNO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93710</ZIPCd>
        </USAddress>
        <EIN>770191730</EIN>
        <PrimaryActivitiesTxt>SUPPORTING ORGANIZATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMUNITY HEALTH PARTNERS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>45 RIVER PARK PLACE WEST SUITE 507</AddressLine1Txt>
          <CityNm>FRESNO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93720</ZIPCd>
        </USAddress>
        <EIN>852103299</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>AMI REALTY PARTNERS LP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1560 E SHAW AVENUE</AddressLine1Txt>
          <CityNm>FRESNO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93710</ZIPCd>
        </USAddress>
        <EIN>203709876</EIN>
        <PrimaryActivitiesTxt>REAL PROPERTY RENTAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY HEALTH ENTERPRISES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>789 N MEDICAL CENTER DRIVE EAST</AddressLine1Txt>
          <CityNm>CLOVIS</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93611</ZIPCd>
        </USAddress>
        <EIN>770175659</EIN>
        <PrimaryActivitiesTxt>PHARMACY SALES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>3617804</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>610416</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY CARE HEALTH PLAN INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>789 N MEDICAL CENTER DRIVE EAST</AddressLine1Txt>
          <CityNm>CLOVIS</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93611</ZIPCd>
        </USAddress>
        <EIN>770246798</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE PLAN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>65882340</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>12261539</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY INSURANCE SERVICES COMPANY</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>789 N MEDICAL CENTER DRIVE EAST</AddressLine1Txt>
          <CityNm>CLOVIS</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93611</ZIPCd>
        </USAddress>
        <EIN>980674776</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>8548324</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>28212971</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>1</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>FRESNO COMMUNITY HOSPITAL &amp; MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>220833934</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY HEALTH ENTERPRISES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>733784</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>460043</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>228278</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY HEALTH PARTNERS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>334592</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY CARE HEALTH PLAN INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>2389603</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
