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        <TotalRevenueColumn>0</TotalRevenueColumn>
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      <NetIncomeFromGaming>
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      <GrantsToDomesticOrgs>
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      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>500384</Total>
        <ManagementAndGeneral>500384</ManagementAndGeneral>
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      <CompDisqualPersons>
        <Total>0</Total>
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      <OtherSalariesAndWages>
        <Total>46454976</Total>
        <ProgramServices>41416613</ProgramServices>
        <ManagementAndGeneral>5038363</ManagementAndGeneral>
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      <PensionPlanContributions>
        <Total>1571769</Total>
        <ProgramServices>1402549</ProgramServices>
        <ManagementAndGeneral>169220</ManagementAndGeneral>
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      <OtherEmployeeBenefits>
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      <FeesForServicesManagement>
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      <FeesForServicesLegal>
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        <ManagementAndGeneral>22284</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
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        <ManagementAndGeneral>108731</ManagementAndGeneral>
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      <FeesForServicesLobbying>
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      <FeesForServicesProfFundraising>
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      <FeesForServicesInvstMgmntFees>
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      <Advertising>
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      </Advertising>
      <OfficeExpenses>
        <Total>0</Total>
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      <InformationTechnology>
        <Total>0</Total>
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      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
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        <ProgramServices>3907829</ProgramServices>
        <ManagementAndGeneral>1228953</ManagementAndGeneral>
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      <TravelEntrtnmntPublicOfficials>
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      <ConferencesMeetings>
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      <Interest>
        <Total>76982</Total>
        <ProgramServices>76982</ProgramServices>
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      <PaymentsToAffiliates>
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        <ProgramServices>957937</ProgramServices>
        <ManagementAndGeneral>859119</ManagementAndGeneral>
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        <ManagementAndGeneral>87993</ManagementAndGeneral>
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        <ManagementAndGeneral>1216844</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>Supplies</Description>
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        <ManagementAndGeneral>138779</ManagementAndGeneral>
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        <EOY>3643041</EOY>
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        <EOY>25960242</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
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      <TotalLiabNetAssetsFundBalances>
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        <EOY>76158834</EOY>
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      <ReconcilationRevenueExpenses>3516005</ReconcilationRevenueExpenses>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementSeparate>X</FinancialStatementSeparate>
      </FSAuditedBasis>
      <AuditCommittee>true</AuditCommittee>
      <FederalGrantAuditRequired>true</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>true</FederalGrantAuditPerformed>
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    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="12000229" softwareVersion="2012v2.0">
      <PubliclySupportedOrg170b1Avi>X</PubliclySupportedOrg170b1Avi>
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        <CurrentTaxYearMinus3Years>29847072</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>34795964</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>34575183</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>37900405</CurrentTaxYear>
        <Total>162106075</Total>
      </GiftsGrantsContribReceived170>
      <TaxRevLeviedForOrgBenefit170>
        <Total>0</Total>
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      <ValueSrvcFcltsFurnishedByGovt>
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        <CurrentTaxYearMinus4Years>24987451</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>29847072</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>34795964</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>34575183</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>37900405</CurrentTaxYear>
        <Total>162106075</Total>
      </Total170>
      <AmountsSubstContributorsTotal>0</AmountsSubstContributorsTotal>
      <PublicSupportTotal170>162106075</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <CurrentTaxYearMinus4Years>243044</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>39900</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>65076</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>72743</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>32845</CurrentTaxYear>
        <Total>453608</Total>
      </GrossInvestmentIncome170>
      <NetUBI>
        <Total>0</Total>
      </NetUBI>
      <OtherIncome170>
        <CurrentTaxYearMinus4Years>445775</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>287221</CurrentTaxYearMinus3Years>
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        <CurrentTaxYearMinus1Year>1102957</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>236994</CurrentTaxYear>
        <Total>2484741</Total>
      </OtherIncome170>
      <TotalSupport>165044424</TotalSupport>
      <GrossReceiptsFromAdmissionsEtc>204971034</GrossReceiptsFromAdmissionsEtc>
      <PublicSupportPertcentage170>0.98220</PublicSupportPertcentage170>
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    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="12000229" softwareVersion="2012v2.0">
      <ContributorInfo>
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        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
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          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
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    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="12000229" softwareVersion="2012v2.0">
      <Land>
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        <BookValue>3828368</BookValue>
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        <BookValue>14151950</BookValue>
      </Buildings>
      <Equipment>
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        <BookValue>9023697</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>9634637</OtherCostOrOtherBasis>
        <BookValue>9634637</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>36638652</TotalOfBookValueLandBuildings>
      <OtherLiabilities>
        <Description>Overpayment of 3rd Party Payor Settlemen</Description>
        <Amount>1323929</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>1323929</TotalOfAmounts>
      <FootnoteInPartXIII>X</FootnoteInPartXIII>
      <TotRevenueEtcAuditedFinclStmt>86221829</TotRevenueEtcAuditedFinclStmt>
      <DonatedSrvcAndUseOfFacilities>92880</DonatedSrvcAndUseOfFacilities>
      <RevenueNotRptdF990>92880</RevenueNotRptdF990>
      <RevenueSubtotal>86128949</RevenueSubtotal>
      <TotalRevenuePerForm990>86128949</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>82705824</TotExpensesEtcAuditedFinclStmt>
      <DonatedServicesUseOfFacilities>92880</DonatedServicesUseOfFacilities>
      <ExpensesNotRptdF990>92880</ExpensesNotRptdF990>
      <ExpensesSubtotal>82612944</ExpensesSubtotal>
      <TotalExpensesPerForm990>82612944</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIII>
        <Identifier>Part X</Identifier>
        <ReturnReference>Part X : FIN48 Footnote</ReturnReference>
        <Explanation>The accounting standard on accounting for uncertainty in income taxes addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under the guidance, the Clinic may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. Examples of tax positions include the tax-exempt status of the Clinic and various positions related to the potential sources of unrelated business taxable income (UBIT). The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. There were no unrecognized tax benefits identified or recorded as liabilities for fiscal year 2013.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="12000229" softwareVersion="2012v2.0">
      <CompensationCommittee>X</CompensationCommittee>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
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      <AnyNonFixedPayments>false</AnyNonFixedPayments>
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      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
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        <Title>CEO</Title>
        <BaseCompensationFilingOrg>257765</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>8646</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>15000</DeferredCompFilingOrg>
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        <TotalCompensationFilingOrg>297323</TotalCompensationFilingOrg>
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        <NamePerson>Rhonda Robinson</NamePerson>
        <Title>Physician</Title>
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        <OtherCompensationFilingOrg>180</OtherCompensationFilingOrg>
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        <NamePerson>Luis Lopez</NamePerson>
        <Title>Physician</Title>
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        <DeferredCompFilingOrg>8640</DeferredCompFilingOrg>
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        <NamePerson>Kami Jow</NamePerson>
        <Title>Physician</Title>
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        <Title>Physician</Title>
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        <NamePerson>Consuelo Cantu</NamePerson>
        <Title>CFO</Title>
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        <OtherCompensationFilingOrg>1757</OtherCompensationFilingOrg>
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        <TotalCompensationFilingOrg>203061</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Chibuike Anucha</NamePerson>
        <Title>Physician</Title>
        <BaseCompensationFilingOrg>465592</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>414</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>8248</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>18827</NontaxableBenefitsFilingOrg>
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    </IRS990ScheduleJ>
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      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>All governing documents, financial statements and form 990 are available to thepublic upon written request. The form 990 are also available online.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>The organization has a personnel committee composed of members of the Board of Directors. The committee uses a formal salary survey process to determine appropriate salary scale for all positions and makes recommendations to Board of Directors. Surveys comprise of like non-profit organizations, industry specific, National and State Primary Care Association Surveys.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15a</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</ReturnReference>
        <Explanation>Compensation for the CEO is determined and approved by Clinica Sierra Vista's Board of Directors during contract renewal and negotiations. The CEO determines and approves compensation for officers and key employees based on board approved salary schedule and individual's qualifications.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>Clinica Sierra Vista has a Conflict of Interest policy in the Employee personnel manual section 428.1 and Administrative Manual section 1.1029. Each employee is given the manual and policy at hire. Each employee completes a conflict of interest statement each year. 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. Human Resources and supervisors monitor adherence to this policy closely.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11b: Form 990 Review Process</ReturnReference>
        <Explanation>Comptroller compiles and verifies 990 data. Final draft is reviewed by CEO and CFOprior to submission.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>