﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-11-15T15:16:50-06:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>871353108</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>EISNER ADVISORY GROUP LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>4225 EXECUTIVE SQUARE SUITE 1150</AddressLine1Txt>
        <CityNm>LA JOLLA</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>92037</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>820635784</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>GARY AND MARY WEST SENIOR SERVICES INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>GARY</BusinessNameControlTxt>
      <PhoneNum>7602802230</PhoneNum>
      <USAddress>
        <AddressLine1Txt>1706 DESCANSO AVE</AddressLine1Txt>
        <CityNm>SAN MARCOS</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>92078</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>TIMOTHY LASH</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>7602802230</PhoneNum>
      <SignatureDt>2024-11-13</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>MARY MCGROARTY</PreparerPersonNm>
      <PTIN>P00735101</PTIN>
      <PhoneNum>8585589200</PhoneNum>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2024-10-15 13:58:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>GARY AND MARY WEST PACE</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>TIMOTHY LASH</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>1706 DESCANSO AVE</AddressLine1Txt>
        <CityNm>SAN MARCOS</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>92078</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>41352647</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>HTTPS://WESTPACE.NET/</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2017</FormationYr>
      <LegalDomicileStateCd>DE</LegalDomicileStateCd>
      <ActivityOrMissionDesc>PRIMARILY TO OPERATE A HIGH-QUALITY, AFFORDABLE OUTPATIENT CLINIC FOR THE MEDICAL (CONT.) CARE OF SENIORS UNDER A FEDERAL AND STATE GOVERNMENTAL PROGRAM KNOWN AS PACE, IN ORDER TO ENABLE SENIORS TO LIVE IN THEIR COMMUNITIES AS INDEPENDENTLY AS POSSIBLE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>3</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>3</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>160</TotalEmployeeCnt>
      <TotalVolunteersCnt>3</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>13217</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>427960</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>30005120</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>40848512</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>23341</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>54</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>647</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>76121</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>30042325</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>41352647</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>8086403</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>10816361</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>18579912</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>33185775</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>26666315</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>44002136</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>3376010</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-2649489</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>16575539</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>14440351</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>4143178</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>4657479</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>12432361</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>9782872</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>PRIMARILY TO OPERATE A HIGH-QUALITY, AFFORDABLE OUTPATIENT CLINIC FOR THE MEDICAL CARE OF SENIORS UNDER A FEDERAL AND STATE GOVERNMENTAL PROGRAM KNOWN AS PACE, IN ORDER TO ENABLE SENIORS TO LIVE IN THEIR COMMUNITIES AS INDEPENDENTLY AS POSSIBLE.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>41874182</ExpenseAmt>
      <RevenueAmt>40924633</RevenueAmt>
      <Desc>GARY AND MARY WEST SENIOR SERVICES, DOING BUSINESS AS GARY AND MARY WEST PACE (GMWP), ENABLES SENIORS TO SUCCESSFULLY AGE IN PLACE AND MAINTAIN THEIR HIGHEST LEVEL OF INDEPENDENCE THROUGH THE SERVICES OF THEIR PACE (PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY) PROGRAM. AFTER A PERIOD OF CONSTRUCTION, PROGRAM SETUP, REGULATORY APPROVAL AND HIRING PROCESSES, THE FIRST PARTICIPANTS WERE WELCOMED TO OUR PACE PROGRAM IN 2019. WHEN A PARTICIPANT QUALIFIES AND ENROLLS IN OUR PACE PROGRAM, GMWP ASSUMES RESPONSIBILITY FOR PROVIDING 100% OF THE MEDICAL NEEDS OF THE ENROLLED INDIVIDUAL. THESE SENIORS ARE TYPICALLY VERY FRAIL, WITH LIMITED FINANCIAL RESOURCES AND IN NEED OF HELP IN COORDINATING THEIR ACCESS TO CARE. GMWP MEETS THESE NEEDS THROUGH A HIGHLY MANAGED CLINIC-BASED APPROACH, WHERE OUR OWN PHYSICIANS, MEDICAL, SOCIAL SERVICES AND OTHER STAFF SEE PARTICIPANTS FREQUENTLY, COORDINATING CARE AT EVERY LEVEL. SOME OF THE UNIQUE INCLUDED SERVICES ARE TRANSPORTATION, SOCIAL PROGRAMS, NUTRITIONAL ASSISTANCE, HOME CARE, AND ADULT DAY SERVICES, AMONG OTHERS. MANY OF THESE SERVICES WOULD NOT TYPICALLY BE PAID FOR BY EITHER MEDICARE OR MEDICAID BUT HAVE PROVEN TO BE VERY EFFECTIVE IN HELPING THE PARTICIPANT REMAIN AS HEALTHY AND INDEPENDENT AS POSSIBLE. IN 2019, GARY AND MARY WEST PACE ALSO WELCOMED A NON-PROFIT SENIOR DENTAL PROVIDER AS A TENANT IN OUR SPACE ALSO GIVING OUR PARTICIPANTS CONVENIENT ACCESS TO DENTAL CARE.</Desc>
      <TotalProgramServiceExpensesAmt>41874182</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039500001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039500001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039500001">0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">0</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">1</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>36</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>160</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>3</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>3</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>1</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>CA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>PATRICIA MEYER</PersonNm>
        <PhoneNum>7602802230</PhoneNum>
        <USAddress>
          <AddressLine1Txt>1706 DESCANSO AVE</AddressLine1Txt>
          <CityNm>SAN MARCOS</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>92078</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY LASH</PersonNm>
        <TitleTxt>OFFICER/PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JON ZIFFERBLATT</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR ZIA AGHA</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL M CAPONETTO</PersonNm>
        <TitleTxt>DIRECTOR/CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHARLES V SEDERSTROM</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAMELA B SMITH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RENATA R SMITH</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>285154</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28524</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR ROSS E COLT</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>246339</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16837</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MELANIE CLARK</PersonNm>
        <TitleTxt>HR DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>175111</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26798</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SAMAR HIREISH</PersonNm>
        <TitleTxt>CLINIC DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>180745</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8641</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NEHA JAIN SAMPATH</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>275984</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8585</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>OFRA PAZ</PersonNm>
        <TitleTxt>BUSINESS DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>187550</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8030</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHANIE THOMPSON</PersonNm>
        <TitleTxt>BEHAVIORAL HEALTH DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>152685</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23750</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1503568</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>121165</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>7</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NINETY-NINE TEN BUSINESS SOLUTIONS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5800 ARMADA DRIVE SUITE 100</AddressLine1Txt>
            <CityNm>CARLSBAD</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92008</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT SERVICES</ServicesDesc>
        <CompensationAmt>391155</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>373506</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>54454</AllOtherContributionsAmt>
      <NoncashContributionsAmt>3165</NoncashContributionsAmt>
      <TotalContributionsAmt>427960</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>CAPITATION REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>39645279</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39645279</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RESEARCH REVENUE</Desc>
        <BusinessCd>541700</BusinessCd>
        <TotalRevenueColumnAmt>1200000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1200000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>DENTAL CENTER RENT</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>3233</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3233</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>40848512</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>54</TotalRevenueColumnAmt>
        <ExclusionAmt>54</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>76121</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>76121</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>76121</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>41352647</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>40924633</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>54</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1503569</TotalAmt>
        <ProgramServicesAmt>998330</ProgramServicesAmt>
        <ManagementAndGeneralAmt>505239</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>7542995</TotalAmt>
        <ProgramServicesAmt>7005405</ProgramServicesAmt>
        <ManagementAndGeneralAmt>537590</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>243671</TotalAmt>
        <ProgramServicesAmt>216068</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27603</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>832272</TotalAmt>
        <ProgramServicesAmt>737992</ProgramServicesAmt>
        <ManagementAndGeneralAmt>94280</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>693854</TotalAmt>
        <ProgramServicesAmt>615254</ProgramServicesAmt>
        <ManagementAndGeneralAmt>78600</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>176778</TotalAmt>
        <ProgramServicesAmt>19142</ProgramServicesAmt>
        <ManagementAndGeneralAmt>157636</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>17916</TotalAmt>
        <ManagementAndGeneralAmt>17916</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2429781</TotalAmt>
        <ProgramServicesAmt>1970974</ProgramServicesAmt>
        <ManagementAndGeneralAmt>458807</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>136822</TotalAmt>
        <ProgramServicesAmt>121050</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15772</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>181202</TotalAmt>
        <ProgramServicesAmt>150991</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30211</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>598543</TotalAmt>
        <ProgramServicesAmt>566638</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31905</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>53363</TotalAmt>
        <ProgramServicesAmt>32018</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21345</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>73800</TotalAmt>
        <ProgramServicesAmt>65293</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8507</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>445154</TotalAmt>
        <ProgramServicesAmt>421425</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23729</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>176507</TotalAmt>
        <ProgramServicesAmt>167098</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9409</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>THIRD PARTY CONTRACTED</Desc>
        <TotalAmt>27680940</TotalAmt>
        <ProgramServicesAmt>27680940</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EQUIPMENT &amp; SUPPLIES</Desc>
        <TotalAmt>753127</TotalAmt>
        <ProgramServicesAmt>696960</ProgramServicesAmt>
        <ManagementAndGeneralAmt>56167</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES &amp; PERMITS</Desc>
        <TotalAmt>362243</TotalAmt>
        <ProgramServicesAmt>320486</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41757</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES &amp; SUBSCRIPTIONS</Desc>
        <TotalAmt>87167</TotalAmt>
        <ProgramServicesAmt>77119</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10048</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>12432</TotalAmt>
        <ProgramServicesAmt>10999</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1433</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>44002136</TotalAmt>
        <ProgramServicesAmt>41874182</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2127954</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>8872936</BOYAmt>
        <EOYAmt>6746644</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2809574</BOYAmt>
        <EOYAmt>3678323</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>781663</BOYAmt>
        <EOYAmt>420148</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>5110887</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1974688</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>3355226</BOYAmt>
        <EOYAmt>3136199</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>53688</BOYAmt>
        <EOYAmt>23938</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>702452</BOYAmt>
        <EOYAmt>435099</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>16575539</BOYAmt>
        <EOYAmt>14440351</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>4143178</BOYAmt>
        <EOYAmt>4657479</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>4143178</BOYAmt>
        <EOYAmt>4657479</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>12432361</BOYAmt>
        <EOYAmt>9782872</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>12432361</BOYAmt>
        <EOYAmt>9782872</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>16575539</BOYAmt>
        <EOYAmt>14440351</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-2649489</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>FORM 990, PART IV, LINE 20A:</FormAndLineReferenceDesc>
        <ExplanationTxt>ALTHOUGH THE ORGANIZATION HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE DESCRIBED IN INTERNAL REVENUE CODE SECTION 170(B)(1)(A)(III) BECAUSE IT PROVIDES OUTPATIENT MEDICAL SERVICES, IT IS NOT REQUIRED BY ITS STATE OF OPERATION TO BE LICENSED AS A HOSPITAL. THEREFORE, IT IS NOT REQUIRED TO PROVIDE SCHEDULE H.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039500001">
      <PoliticalExpendituresAmt>0</PoliticalExpendituresAmt>
      <VolunteerHoursCnt>0</VolunteerHoursCnt>
      <Section4955OrganizationTaxAmt>0</Section4955OrganizationTaxAmt>
      <Section4955ManagersTaxAmt>0</Section4955ManagersTaxAmt>
      <TotalDirectLobbyingGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </TotalDirectLobbyingGrp>
      <TotalLobbyingExpendGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </TotalLobbyingExpendGrp>
      <TotalExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </TotalExemptPurposeExpendGrp>
      <LobbyingNontaxableAmountGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </LobbyingNontaxableAmountGrp>
      <GrassrootsNontaxableGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </GrassrootsNontaxableGrp>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>4301418</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1394529</DepreciationAmt>
        <BookValueAmt>2906889</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>310715</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>226804</DepreciationAmt>
        <BookValueAmt>83911</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>498754</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>353355</DepreciationAmt>
        <BookValueAmt>145399</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>3136199</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>41352647</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>41352647</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>41352647</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>44002136</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>44002136</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>44002136</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS GENERALLY EXEMPT FROM INCOME TAXES AS AN ORGANIZATION DESCRIBED UNDER SECTIONS 501(C)(3), 509(A)(1), AND 170(B)(1)(A)(III) OF THE TAX CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE, EXCEPT FOR TAXES ON NET UNRELATED BUSINESS INCOME. SINCE THE ORGANIZATION HAD NO UNRELATED BUSINESS INCOME IN 2023 AND 2022, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. IN ACCORDANCE WITH FASB ASC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE ORGANIZATION EVALUATES ANNUALLY ANY UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN BY APPLYING A THRESHOLD OF MORE-LIKELY-THAN-NOT FOR RECOGNITION. MANAGEMENT EVALUATED ITS TAX POSITIONS AND DETERMINED THAT IT HAS NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2023 AND 2022. THERE HAVE BEEN NO RELATED TAX PENALTIES OR INTEREST, WHICH WOULD BE CLASSIFIED AS TAX EXPENSE IN THE STATEMENTS OF ACTIVITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RENATA R SMITH</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>244154</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>41000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8033</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>20491</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>313678</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR ROSS E COLT</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>189528</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>56811</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>15250</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1587</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>263176</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MELANIE CLARK</PersonNm>
        <TitleTxt>HR DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>149081</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>26030</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12522</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14276</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>201909</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SAMAR HIREISH</PersonNm>
        <TitleTxt>CLINIC DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>153955</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>26790</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7030</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1611</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>189386</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NEHA JAIN SAMPATH</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>275484</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8033</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>552</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>284569</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>OFRA PAZ</PersonNm>
        <TitleTxt>BUSINESS DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>179000</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>8550</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7030</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1000</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>195580</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEPHANIE THOMPSON</PersonNm>
        <TitleTxt>BEHAVIORAL HEALTH DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>152685</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12522</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>11228</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>176435</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>GARY AND MARY WEST HEALTH INSTITUTE</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>COMMON DIRECTOR &amp; COMMON OFFICER</RelationshipDescriptionTxt>
        <TransactionAmt>1200000</TransactionAmt>
        <TransactionDesc>FUNDS RECEIVED TO RESEARCH THE METHODS AND MEANS FOR IMPLEMENTING A PACE PROGRAM WITH SUBSTANTIALLY EXPANDED SERVICES FOR PARTICIPANTS BEYOND THOSE REQUIRED BY FEDERAL AND STATE GOVERNMENTAL AGENCIES.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>JON ZIFFERBLATT, SECRETARY OF GARY AND MARY WEST SENIOR SERVICES, IS ALSO EMPLOYED BY THE GARY AND MARY WEST MANAGEMENT COMPANY. CHARLES SEDERSTROM ACTS AS A DIRECTOR OF THE BOARD FOR BOTH GARY AND MARY WEST SENIOR SERVICES AND GARY AND MARY WEST MANAGEMENT COMPANY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>GARY AND MARY WEST SENIOR SERVICES HAS THREE MEMBERS WHO ALSO SERVE AS DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>ADDITIONAL OR SUCCESSOR MEMBERS OF THE BOARD OF DIRECTORS SHALL BE ELECTED BY THE MEMBERS AS NECESSARY TO FILL EXPIRING, VACANT OR ADDITIONAL POSITIONS, AT THE APPLICABLE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING OF THE MEMBERS CALLED FOR SUCH PURPOSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BYLAWS REQUIRE THAT AMENDMENTS TO THE BYLAWS AND ARTICLES OF INCORPORATION MADE BY THE ORGANIZATION ARE SUBJECT TO APPROVAL BY THE MEMBERS OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 INFORMATION WAS COMPILED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. THE COMPLETED FORM 990 WAS REVIEWED BY THE ORGANIZATION'S PRESIDENT, THE DIRECTOR OF FINANCE AND OUTSIDE LEGAL COUNSEL. UPON SATISFACTORY COMPLETION OF THE REVIEW PROCESS, A DRAFT OF THE FORM 990 WAS CIRCULATED TO THE ORGANIZATION'S GOVERNING BODY FOR REVIEW. THE FORM 990 WAS THEN FILED WITH THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH PRINCIPAL OFFICER, BOARD MEMBER AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SIGNS A STATEMENT ANNUALLY WHICH AFFIRMS THAT PERSON HAS RECEIVED, UNDERSTANDS AND AGREES TO COMPLY WITH THE CONFLICT OF INTEREST POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE OFFICERS OF THE CORPORATION SHALL BE ENTITLED TO SUCH REASONABLE COMPENSATION FOR THEIR SERVICES AS IS APPROVED BY THE BOARD OF DIRECTORS AND TO THE REIMBURSEMENT OF REASONABLE EXPENSES, IF ANY, INCURRED BY THEM AS OFFICERS, IF APPROVED BY THE BOARD OF DIRECTORS, AND NOTHING HEREIN SHALL BE CONSTRUED TO PRECLUDE AN OFFICER FROM SERVING THE CORPORATION IN ANY OTHER CAPACITY AND RECEIVING COMPENSATION FOR SUCH OTHER SERVICES. COMPENSATION FOR THE EXECUTIVE DIRECTOR AND ANY KEY EMPLOYEES OF THE ORGANIZATION ARE DETERMINED BASED ON CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. COMPENSATION IS APPROVED BY AN OFFICER OF THE ORGANIZATION IN ADVANCE OF PAYMENT. RECORDS OF RELATED SURVEYS AND APPROVALS ARE MAINTAINED IN PERSONNEL FILES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON THE REQUEST OF SUCH DOCUMENTS. THE RETURN IS REVIEWED BY THE DIRECTOR OF FINANCE, LEGAL COUNSEL, AND PRESIDENT OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDITED FINANCIAL STATEMENTS WERE REVIEWED AND APPROVED BY THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. UPOM SATISFACTORY COMPLETION OF THE REVIEW PROCESS, A DRAFT OF THE AUDITED FINANCIAL STATEMENTS WAS CIRCULATED TO THE ORGANIZATION'S GOVERNING BOARD FOR REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>