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      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
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      <NetGainOrLossInvestments>
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      <NetIncomeFromFundraisingEvents>
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      <NetIncomeFromGaming>
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      <GrantsToDomesticOrgs>
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      <GrantsToDomesticIndividuals>
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      </GrantsToDomesticIndividuals>
      <ForeignGrants>
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      <BenefitsToMembers>
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      <CompDisqualPersons>
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        <ProgramServices>130458</ProgramServices>
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        <ManagementAndGeneral>45878</ManagementAndGeneral>
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        <ManagementAndGeneral>41203</ManagementAndGeneral>
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        <ProgramServices>3443233</ProgramServices>
        <ManagementAndGeneral>128569</ManagementAndGeneral>
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      <OtherExpenses>
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      <OtherExpenses>
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        <Total>573796</Total>
        <ProgramServices>473624</ProgramServices>
        <ManagementAndGeneral>100172</ManagementAndGeneral>
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        <ManagementAndGeneral>46150</ManagementAndGeneral>
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      <AllOtherExpenses>
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        <ProgramServices>841336</ProgramServices>
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        <Fundraising>0</Fundraising>
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      <InvestmentsPubTradedSecurities>
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      <FollowSFAS117>X</FollowSFAS117>
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      <TotalLiabNetAssetsFundBalances>
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      <ReconcilationRevenueExpenses>6819972</ReconcilationRevenueExpenses>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementSeparate>X</FinancialStatementSeparate>
      <FederalGrantAuditRequired>true</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>true</FederalGrantAuditPerformed>
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    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="10000105" softwareVersion="2010v3.2">
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      <TaxRevLeviedForOrgBenefit170>
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      <ValueSrvcFcltsFurnishedByGovt>
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        <CurrentTaxYearMinus1Year>29847072</CurrentTaxYearMinus1Year>
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        <Total>134796776</Total>
      </Total170>
      <AmountsSubstContributorsTotal>0</AmountsSubstContributorsTotal>
      <PublicSupportTotal170>134796776</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <CurrentTaxYearMinus4Years>370077</CurrentTaxYearMinus4Years>
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        <Total>1246086</Total>
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      <NetUBI>
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        <Total>2412477</Total>
      </OtherIncome170>
      <TotalSupport>138455339</TotalSupport>
      <GrossReceiptsFromAdmissionsEtc>164915121</GrossReceiptsFromAdmissionsEtc>
      <PublicSupportPertcentage170>0.97360</PublicSupportPertcentage170>
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        <ContributorAddressUS>
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        <Depreciation>8455918</Depreciation>
        <BookValue>13720487</BookValue>
      </Buildings>
      <Equipment>
        <OtherCostOrOtherBasis>6287195</OtherCostOrOtherBasis>
        <BookValue>6287195</BookValue>
      </Equipment>
      <TotalOfBookValueLandBuildings>23732117</TotalOfBookValueLandBuildings>
      <OtherLiabilities>
        <Description>Overpayment of 3rd Party Payor Settlemen</Description>
        <Amount>334444</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>334444</TotalOfAmounts>
      <TotalRevenue>76067008</TotalRevenue>
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      <ExcessOrDeficitForYear>6819972</ExcessOrDeficitForYear>
      <ExcessOrDeficitPerFS>6819972</ExcessOrDeficitPerFS>
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    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="10000105" softwareVersion="2010v3.2">
      <CompensationCommittee>X</CompensationCommittee>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
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        <BaseCompensationFilingOrg>249485</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>33746</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>283231</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
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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 on line.</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 and reports directly to the Board of Directors. The committee uses compensation surveys and studies of other nonprofit organizations in California. Compensation of all officers, directors, and key employees are approved by the Board of Directors, and all officers, directors, key employees, and other highly compensated employees have written employment contracts.</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 personnelhandbook. Each employee is given the handbook and this policy is also reviewed witheach new hire. Our policy requires employees to request approval for outside employment:it requires disclosure of potential personal and professional conflicts;and prohibits employees from engaging in business transactions that result in personal gain. Human Resources and supervisors monitor adherence to this policyclosely.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: 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>