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        <PersonNm>LORENA L TOBIAS</PersonNm>
        <TitleTxt>NURSE PRACTIONER</TitleTxt>
        <AverageHoursPerWeekRt>35.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>171061</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2007659</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>11</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <GovernmentGrantsAmt>6974286</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>263367</AllOtherContributionsAmt>
      <NoncashContributionsAmt>161148</NoncashContributionsAmt>
      <TotalContributionsAmt>7237653</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>4201690</TotalRevenueColumnAmt>
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        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>4201690</TotalProgramServiceRevenueAmt>
      <MiscellaneousRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>146</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>81067</UnrelatedBusinessRevenueAmt>
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      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>81213</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>11520556</TotalRevenueColumnAmt>
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        <UnrelatedBusinessRevenueAmt>81067</UnrelatedBusinessRevenueAmt>
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      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>1638005</ProgramServicesAmt>
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      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
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        <ProgramServicesAmt>1813428</ProgramServicesAmt>
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      </PayrollTaxesGrp>
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        <ProgramServicesAmt>372360</ProgramServicesAmt>
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      <FeesForServicesLegalGrp>
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        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>55000</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <OfficeExpensesGrp>
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        <ProgramServicesAmt>70827</ProgramServicesAmt>
        <ManagementAndGeneralAmt>814510</ManagementAndGeneralAmt>
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      </OfficeExpensesGrp>
      <OccupancyGrp>
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        <ManagementAndGeneralAmt>206513</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>27561</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6051</ManagementAndGeneralAmt>
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      </TravelGrp>
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        <ManagementAndGeneralAmt>1001</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
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        <ManagementAndGeneralAmt>143711</ManagementAndGeneralAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>165966</ProgramServicesAmt>
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        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
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        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
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        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
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      <AllOtherExpensesGrp>
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      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>7168962</ProgramServicesAmt>
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      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
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      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
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        <EOYAmt>8739968</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
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      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>4367479</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>496550</EOYAmt>
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        <EOYAmt>3982964</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>13549294</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
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        <EOYAmt>12036892</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>12427814</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
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        <EOYAmt>1111480</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>10000</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>922237</BOYAmt>
        <EOYAmt>1121480</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>13549294</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>273218</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
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        <CurrentTaxYearMinus3YearsAmt>2887715</CurrentTaxYearMinus3YearsAmt>
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        <CurrentTaxYearMinus1YearAmt>3443916</CurrentTaxYearMinus1YearAmt>
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      </TaxRevLeviedOrgnztnlBnft170Grp>
      <GovtFurnSrvcFcltsVl170Grp>
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      </GovtFurnSrvcFcltsVl170Grp>
      <TotalCalendarYear170Grp>
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      <GrossInvestmentIncome170Grp>
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      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
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        <CurrentTaxYearMinus2YearsAmt>53300</CurrentTaxYearMinus2YearsAmt>
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        <CurrentTaxYearMinus1YearAmt>4400</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
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      <PublicSupportCY509Pct>0</PublicSupportCY509Pct>
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      <Form990ScheduleAPartVIGrp>
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      </Form990ScheduleAPartVIGrp>
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      <LeaseholdImprovementsGrp>
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      <EquipmentGrp>
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        <DepreciationAmt>3240210</DepreciationAmt>
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      <OtherLandBuildingsGrp>
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        <DepreciationAmt>465274</DepreciationAmt>
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      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>496550</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>OTHER ASSETS</Desc>
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      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT TO USE ASSETS</Desc>
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      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>3982964</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
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      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>NOTES-LOAN PAYABLE</Desc>
        <Amt>188103</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE OBLIGATION</Desc>
        <Amt>3809440</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>UNEARNED REVENUE</Desc>
        <Amt>0</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>12036892</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ-01">
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      <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>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>223750</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>165958</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>213333</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MANSI SARVAIYA</PersonNm>
        <BaseCompensationFilingOrgAmt>192331</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>6203</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>198534</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LORENA L TOBIAS</PersonNm>
        <BaseCompensationFilingOrgAmt>171061</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>171061</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="22015534">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Draft return provided</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Obtain certification from employees</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation approved by board members</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation approved by board members</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>REAL ESTATE TAXES 5168. 4264. 904. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT 1977709. 0. 1977709. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>DONATION 19639. 19639. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
