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        <CurrentTaxYearMinus1YearAmt>9959658</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10696926</CurrentTaxYearAmt>
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        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft170Grp>
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        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>9719535</CurrentTaxYearMinus4YearsAmt>
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      <SubstantialContributorsTotAmt>0</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>49830021</PublicSupportTotal170Amt>
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        <CurrentTaxYearMinus1YearAmt>12408</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>35970</CurrentTaxYearAmt>
        <TotalAmt>69280</TotalAmt>
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        <TotalAmt>0</TotalAmt>
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        <CurrentTaxYearMinus1YearAmt>85000</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>42500</CurrentTaxYearAmt>
        <TotalAmt>1003127</TotalAmt>
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      <TotalSupportAmt>50902428</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>130588583</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.97893</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.97478</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
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    <IRS990ScheduleB documentId="IRS990ScheduleB">
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          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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        <FilingOrganizationsTotalAmt>88240</FilingOrganizationsTotalAmt>
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      <TotalLobbyingExpendGrp>
        <FilingOrganizationsTotalAmt>88240</FilingOrganizationsTotalAmt>
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      <OtherExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>28996662</FilingOrganizationsTotalAmt>
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      <TotalExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>29084902</FilingOrganizationsTotalAmt>
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      <LobbyingNontaxableAmountGrp>
        <FilingOrganizationsTotalAmt>1000000</FilingOrganizationsTotalAmt>
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      <GrassrootsNontaxableGrp>
        <FilingOrganizationsTotalAmt>250000</FilingOrganizationsTotalAmt>
      </GrassrootsNontaxableGrp>
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <AvgLobbyingNontaxableAmountGrp>
        <CurrentYearMinus3Amt>1000000</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>1000000</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>1000000</CurrentYearMinus1Amt>
        <CurrentYearAmt>1000000</CurrentYearAmt>
        <TotalAmt>4000000</TotalAmt>
      </AvgLobbyingNontaxableAmountGrp>
      <LobbyingCeilingAmt>6000000</LobbyingCeilingAmt>
      <AvgTotalLobbyingExpendGrp>
        <CurrentYearMinus3Amt>142773</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>96184</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>96101</CurrentYearMinus1Amt>
        <CurrentYearAmt>88240</CurrentYearAmt>
        <TotalAmt>423298</TotalAmt>
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      <AvgGrassrootsNontaxableGrp>
        <CurrentYearMinus3Amt>250000</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>250000</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>250000</CurrentYearMinus1Amt>
        <CurrentYearAmt>250000</CurrentYearAmt>
        <TotalAmt>1000000</TotalAmt>
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      <GrassrootsCeilingAmt>1500000</GrassrootsCeilingAmt>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
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      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp>
        <OtherCostOrOtherBasisAmt>787991</OtherCostOrOtherBasisAmt>
        <BookValueAmt>787991</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
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        <DepreciationAmt>5947954</DepreciationAmt>
        <BookValueAmt>18701290</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>144911</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>102637</DepreciationAmt>
        <BookValueAmt>42274</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>4973219</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3963840</DepreciationAmt>
        <BookValueAmt>1009379</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>128331</OtherCostOrOtherBasisAmt>
        <BookValueAmt>128331</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>20669265</TotalBookValueLandBuildingsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <TotalLiabilityAmt>0</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>41233796</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>41233796</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>464956</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>464956</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>41698752</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>37028634</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>37028634</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>464956</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>464956</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>37493590</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The Health System is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code and a similar provision of state law. The Health System believes that it does not have any uncertain tax positions that are material to the financial statements. The Health System's income tax returns for 2016 through the current period remain open to examination by the Internal Revenue Service and relevant state authorities.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT Reclassed TO EXPENSES FOR 990 REPORTING: $404,363 Pass-through grant income not reported on audit 60,593</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT Reclassed TO EXPENSES FOR 990 REPORTING: $404,363 Pass-through grant income not reported on audit 60,593</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="IRS990ScheduleG">
      <FundraisingEventInformationGrp>
        <Event1Nm>EVENING THEATRE</Event1Nm>
        <GrossReceiptsEvent1Amt>60593</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>60593</CharitableContriEvent1Amt>
        <OtherEventsTotalCnt>0</OtherEventsTotalCnt>
        <GrossReceiptsOtherEventsAmt>0</GrossReceiptsOtherEventsAmt>
        <CharitableContriOtherEventsAmt>0</CharitableContriOtherEventsAmt>
        <GrossRevenueOtherEventsAmt>0</GrossRevenueOtherEventsAmt>
        <GrossReceiptsTotalAmt>60593</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>60593</CharitableContributionsTotAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jeanne Darricades</PersonNm>
        <TitleTxt>Chief Executive Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>179177</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>8101</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>7017</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>2396</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>196691</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Adam Roberts</PersonNm>
        <TitleTxt>Chief Operating Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>161878</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>3145</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>15756</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>180779</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Emelin Martinez</PersonNm>
        <TitleTxt>Chief Medical Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>180312</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>3757</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3150</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>6609</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9639</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>203467</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Stacey Robben</PersonNm>
        <TitleTxt>Chief Dental Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>150902</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>958</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>6205</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10229</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>168294</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Patrick Smith</PersonNm>
        <TitleTxt>Physician/Regional Medical Off</TitleTxt>
        <BaseCompensationFilingOrgAmt>247123</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>102</BonusFilingOrganizationAmount>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Phyllis Pennington</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>205741</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>10102</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>12275</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>228118</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Scott DeRuiter</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>203933</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>102</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8123</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>5449</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>217607</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Susan Kasza</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>198069</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>102</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2200</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>1860</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9607</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>211838</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Allison Lind</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>149982</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>101</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>26804</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7232</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16315</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>200434</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
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      <ArtHistoricalTreasuresGrp />
      <ArtFractionalInterestGrp />
      <BooksAndPublicationsGrp />
      <ClothingAndHouseholdGoodsGrp />
      <CarsAndOtherVehiclesGrp />
      <BoatsAndPlanesGrp />
      <IntellectualPropertyGrp />
      <SecuritiesPubliclyTradedGrp />
      <SecuritiesCloselyHeldStockGrp />
      <SecurPrtnrshpTrustIntrstsGrp />
      <SecuritiesMiscellaneousGrp />
      <QualifiedContribHistStructGrp />
      <QualifiedContribOtherGrp />
      <RealEstateResidentialGrp />
      <RealEstateCommercialGrp />
      <RealEstateOtherGrp />
      <CollectiblesGrp />
      <FoodInventoryGrp />
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <NoncashContributionsRptF990Amt>452562</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>stated value</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <TaxidermyGrp />
      <HistoricalArtifactsGrp />
      <ScientificSpecimensGrp />
      <ArchaeologicalArtifactsGrp />
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>WIC Vouchers</Desc>
        <ContributionCnt>0</ContributionCnt>
        <NoncashContributionsRptF990Amt>805557</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>STATED VALUE</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTINUED: THE MISSION OF THE ORGANIZATION DIRECTS VALLEY-WIDE'S SCOPE OF SERVICES WHICH IS TO PROVIDE QUALITY, COMPREHENSIVE HEALTH CARE SERVICES IN A RESPECTFUL AND INCLUSIVE MANNER, WITH SPECIAL CONSIDERATION FOR MEDICALLY UNDERSERVED POPULATIONS. THIS SPECIFICALLY INCLUDES PATIENTS WHO ARE UNINSURED, UNDERINSURED, OR WHO HAVE LIMITED ACCESS TO PRIMARY HEALTH AND DENTAL CARE SERVICES. VALLEY WIDE PROVIDES SAFE AND EFFECTIVE COMPREHENSIVE PRIMARY AND ORAL HEALTH CARE SERVICES, IN ADDITION TO A FARMWORKER HEALTH SERVICE PROGRAM THAT PROVIDES SERVICES THROUGH VOUCHERS IN AREAS OF THE STATE THAT DO NOT HOUSE C/MHCS, AND TO IMPROVE THE HEALTH STATUS OF UNDERSERVED AND VULNERABLE POPULATIONS. DURING FISCAL YEAR 2018/2019 VALLEY WIDE PROVIDED 130,789 PATIENT SERVICES VISITS. PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED AT THE MONTHLY BOARD OF DIRECTORS MEETING PRIOR TO THE SUBMISSION OF THE 990 TO THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEWED ANNUALLY, CONFLICTS ARE DECLARED AT THE BEGINNING OF EACH BOARD OF DIRECTORS MEETING. EMPLOYEES ARE REQUIRED TO UPDATE ON AN ANNUAL BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>MARKET SURVEY FROM NUMEROUS SOURCES, INCLUDING CCHN, BOFL AND MOUNTAIN STATE EMPLOYERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>