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        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1980861</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>79808</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jobe Meredith</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>50.50</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1221104</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>57975</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>McCollough Brooke</PersonNm>
        <TitleTxt>President</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>699482</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>83138</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Delmore Katie</PersonNm>
        <TitleTxt>Treasurer/Asst Secretary</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>439827</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>57785</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stevens Eric</PersonNm>
        <TitleTxt>Pres, Northern California Network</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>45.50</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1886146</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>57975</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Pretzlaff Robert</PersonNm>
        <TitleTxt>Patient Care Executive</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>641240</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>68468</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stewart Donovan</PersonNm>
        <TitleTxt>Patient Care Executive</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>430256</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44546</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Karagounis Timothy</PersonNm>
        <TitleTxt>Operations Excecutive</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>386388</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>56429</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Brown Mary</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>497945</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>84246</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Sandhu Navneet</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>269434</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>47165</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Marsh Kevin</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>300791</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13296</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Nguyen Tin</PersonNm>
        <TitleTxt>Director, Pharmacy</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>264428</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21470</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Pascua Helen</PersonNm>
        <TitleTxt>RN, First Assistant</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>260422</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>165</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Wolcott Daniel</PersonNm>
        <TitleTxt>Former President thru 12/20</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>704271</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>65778</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Larsen David - Former</PersonNm>
        <TitleTxt>Finance Officer, CCR thru 04/19</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>573565</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>59142</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Whitney Jason - Former</PersonNm>
        <TitleTxt>Treasurer/Asst Secr thru 08/22</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>50.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>531850</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>79794</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Wing Bill - Former</PersonNm>
        <TitleTxt>Dir/Asst Secr/Vice Chair thru 01/22</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>273263</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Nahapetian Arby - Former</PersonNm>
        <TitleTxt>Care Div Medical Officer thru 02/22</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>50.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1759258</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>79808</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jahn Andrew - Former</PersonNm>
        <TitleTxt>Care Division President thru 02/22</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>50.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>693217</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>59411</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cornwell Eric - Former</PersonNm>
        <TitleTxt>Medical Officer thru 03/23</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>199641</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23860</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1593020</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>19096628</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>1164226</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>443</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Galen Inpatient Physicians Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2100 Powell Street Suite 400</AddressLine1Txt>
            <CityNm>Emeryville</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>94608</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Medical services</ServicesDesc>
        <CompensationAmt>4575686</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PT Solutions Holdings LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 724557</AddressLine1Txt>
            <CityNm>Atlanta</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>31139</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Medical and management services</ServicesDesc>
        <CompensationAmt>3521940</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Crothall Healthcare Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>13028 Collections Center Dr</AddressLine1Txt>
            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60693</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Patient transport, courier, laundry</ServicesDesc>
        <CompensationAmt>3380418</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CEP America Anesthesia PC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2100 Powell Street Suite 900</AddressLine1Txt>
            <CityNm>Emeryville</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>94608</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Medical services</ServicesDesc>
        <CompensationAmt>3240747</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Aya Healthcare Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 674907</AddressLine1Txt>
            <CityNm>Dallas</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75267</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Staffing</ServicesDesc>
        <CompensationAmt>2206600</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>50</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>17116012</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>2295318</AllOtherContributionsAmt>
      <TotalContributionsAmt>19411330</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient service revenue</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>285786586</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>285786586</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Revenue/subsidy from related orgs</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>2233928</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2233928</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Dietary/cafeteria revenue</Desc>
        <BusinessCd>722514</BusinessCd>
        <TotalRevenueColumnAmt>933452</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>933452</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Related rental revenue</Desc>
        <BusinessCd>532000</BusinessCd>
        <TotalRevenueColumnAmt>653843</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>653843</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>13017528</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13046027</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>-28499</UnrelatedBusinessRevenueAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>302625337</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>164105</TotalRevenueColumnAmt>
        <ExclusionAmt>164105</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>16105</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>37670</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>-21565</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-21565</TotalRevenueColumnAmt>
        <ExclusionAmt>-21565</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>322179207</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>302653836</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>-28499</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>142540</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>222990</TotalAmt>
        <ProgramServicesAmt>222990</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>101293922</TotalAmt>
        <ProgramServicesAmt>89350300</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11607264</ManagementAndGeneralAmt>
        <FundraisingAmt>336358</FundraisingAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>4379288</TotalAmt>
        <ProgramServicesAmt>3862924</ProgramServicesAmt>
        <ManagementAndGeneralAmt>501822</ManagementAndGeneralAmt>
        <FundraisingAmt>14542</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>14594152</TotalAmt>
        <ProgramServicesAmt>12572654</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1964046</ManagementAndGeneralAmt>
        <FundraisingAmt>57452</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>7664886</TotalAmt>
        <ProgramServicesAmt>6639006</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1000766</ManagementAndGeneralAmt>
        <FundraisingAmt>25114</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>20592811</TotalAmt>
        <ManagementAndGeneralAmt>20592811</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>661498</TotalAmt>
        <ManagementAndGeneralAmt>661498</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>12368</TotalAmt>
        <ManagementAndGeneralAmt>12368</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>25511</TotalAmt>
        <ProgramServicesAmt>25511</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>43487762</TotalAmt>
        <ProgramServicesAmt>41524389</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1963373</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>343247</TotalAmt>
        <ManagementAndGeneralAmt>343247</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>950622</TotalAmt>
        <ProgramServicesAmt>923596</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26977</ManagementAndGeneralAmt>
        <FundraisingAmt>49</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>14330876</TotalAmt>
        <ProgramServicesAmt>2101580</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12228296</ManagementAndGeneralAmt>
        <FundraisingAmt>1000</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>8109023</TotalAmt>
        <ProgramServicesAmt>8093120</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15903</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>85971</TotalAmt>
        <ProgramServicesAmt>59216</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26755</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>106033</TotalAmt>
        <ProgramServicesAmt>41764</ProgramServicesAmt>
        <ManagementAndGeneralAmt>64269</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>5708081</TotalAmt>
        <ProgramServicesAmt>5708081</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>10282905</TotalAmt>
        <ProgramServicesAmt>10186683</ProgramServicesAmt>
        <ManagementAndGeneralAmt>96222</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>2461845</TotalAmt>
        <ProgramServicesAmt>2461345</ProgramServicesAmt>
        <ManagementAndGeneralAmt>500</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Patient care supplies</Desc>
        <TotalAmt>45485817</TotalAmt>
        <ProgramServicesAmt>45485817</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Quality assurance fee</Desc>
        <TotalAmt>16504977</TotalAmt>
        <ProgramServicesAmt>16504977</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Leased equipment expens</Desc>
        <TotalAmt>498415</TotalAmt>
        <ProgramServicesAmt>495794</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2621</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>14388012</TotalAmt>
        <ProgramServicesAmt>14095188</ProgramServicesAmt>
        <ManagementAndGeneralAmt>292824</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>312191012</TotalAmt>
        <ProgramServicesAmt>260354935</ProgramServicesAmt>
        <ManagementAndGeneralAmt>51401562</ManagementAndGeneralAmt>
        <FundraisingAmt>434515</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>3448280</EOYAmt>
      </SavingsAndTempCashInvstGrp>
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        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Section B</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility Reporting Group A</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility Reporting Group A consists of:</FormAndLineReferenceDesc>
        <ExplanationTxt>- Facility 1: Lodi Memorial Hospital Association, Inc. DBA A, - Facility 2: Lodi Memorial Hospital - West DBA AHLM</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility Reporting Group - A Part V, Section B, line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>The San Joaquin County 2022 Community Health Needs Assessment (CHNA) presents a comprehensive picture of community health that encompasses the conditions that impact health in the County. From data collection and analysis to the identification of prioritized needs, the development of the 2022 CHNA report has been an inclusive and comprehensive process guided by a Core Team planning group and broadly representative Steering Committee, with input from hundreds of community residents. The process in 2022 included interviews with ten key informants, 29 focus group discussions with 291 diverse community residents. These individuals included representatives from local governmental and public health agencies, community-based organizations, and leaders, representatives, or members of underserved, low-income, and racial/ethnic populations. Secondary data analyses of over 100 indicators, created a robust picture of the issues affecting people's health where they live, work, and play. The 2022 CHNA utilized a mixed-methods approach. San Joaquin County Public Health Services epidemiologists compiled a comprehensive set of secondary data from national, statewide, and local sources to provide a multi-faceted picture of health in San Joaquin County. These data were compared to benchmark data and analyzed to identify potential areas of need. In addition, Ad Lucem Consulting, in concert with the Core Team, collected primary data via key informant interviews and focus groups that offered a wide range of opinions about issues that most impact the health of the community, as well as examples of existing resources that work to address those needs, and suggestions for continued progress in improving these issues. The data used for this CHNA follows the health needs organization and indicators found in the Kaiser Permanente (KP) Community Health Data Platform. The most up-to-date data were included and data by race/ethnicity were also compiled, as well as a number of additional demographic indicators. The analyzed quantitative and qualitative data were triangulated to identify the top health needs in the County.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility Reporting Group - A Part V, Section B, line 6a:</FormAndLineReferenceDesc>
        <ExplanationTxt>Adventist Health Lodi Memorial participated with Dameron Hospital, Dignity Health-St. Joseph's Medical Center and Behavioral Health Center, Kaiser Permanente, and San Joaquin County Clinics/San Joaquin General Hospital in the 2022 CHNA.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility Reporting Group - A Part V, Section B, line 6b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Core team members that participated in the 2022 CHNA included: Community Foundation of San Joaquin, Community Medical Centers, First 5 San Joaquin, Health Net, Health Plan of San Joaquin, San Joaquin County Office of Education, San Joaquin County Public Health Services, Sutter Health Valley Area and University of the Pacific. Steering Committee members included: 211 San Joaquin, Amelia Adams Whole Life Center, Asian Pacific Self-Development and Residential Association (APSARA), Boys and Girls Club, Catholic Charities Stockton Diocese, Child Abuse Prevention Council, City of Stockton, Office of the Mayor, Office of Violence Prevention, Data Co-op, Interim Director, Delta Health Care, Department of Health and Human Services, Region 9, El Concilio, Emergency Food Bank, Little Manila Rising, LOVE Inc. Manteca, Mary Magdalene Community Services Public Health Advocates, Reinvent South Stockton Coalition, San Joaquin PRIDE Center, Sierra Vista Homes, Residents Council, SJC Behavioral Health Services, SJC Children's Alliance, SJC Clinics, SJC Council of Governments, Early Childhood Education, Comprehensive Health Programs. SJC Health Care Services Agency and Whole Person Care Program, SJC Human Services Agency: Aging and Community Services, St. Mary's Dining Room, Stocktonians Taking Action to Neutralize Drugs (STAND), Faith in the Valley, Health Force Partners, Hispanic Chamber of Commerce, Stockton NAACP, Third City Coalition, Visionary Home Builders and Women's Center and Youth Services Agency.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility Reporting Group - A Part V, Section B, line 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>Tax year 2024 was Year Two of the Implementation Strategy for the 2022 Community Health Needs Assessment. All programs and activities provided to the community were in response to the priority health needs identified in the 2022 CHNA. Our 2022 CHNA identified three areas of significant need: Access to Care, Financial Stability and Mental Health. Priority Need One - Access to Care.The goal is to collaborate with community partners to provide older adults with access to routine medical and social care to alleviate isolation and provide timely care of non-chronic conditions. In 2024, the Hospital established a relationship with the LOEL Senior Center in Lodi to provide health content for their monthly newsletter sent to clients and families. So far, we have promoted the Lodi Memorial Hospital Foundation's Walk for the Health of It event, the Blue Zones Power 9 for health (infographic), and the community Stroke Support Group, hosted at the Hospital. Adventist Health Lodi Memorial (AHLM) supported Lawrence Elementary School with a significant number of lice treatment kits for students and families. They explained that when lice infestations occur at students' homes the result is a high level of student absenteeism. The kits allow families to effectively manage the condition (especially those lacking healthcare coverage or transportation) and maintain school attendance. In June 2024, we provided Lawrence Elementary School with 150 lice treatment kits, with a value of more than $4,000. This will be used for students/families during the 2024-25 school year. In addition, AHLM was able to hire seven providers to address access to care issues in 2024. The hospital service area has a population of 348,019 and 79.93 providers per 100,000 people. This is well below the national average of 116.46 primary care providers per 100,000 residents. Successful recruitment of providers included two interventional cardiologists; one gastroenterologist; one internal medicine physician; one orthopedic surgeon; one cardiothoracic surgeon; and a family medicine physician assistant. The Hospital also provides enrollment assistance for health insurance. Priority Need Two - Financial Stability.The goal is to provide supportive environment for members of vulnerable populations to gain exposure and skills for employability in allied health professions through internships, externships, and apprenticeship opportunities in medical and allied health professions. Opportunities in 2024 included: 1. Partnerships with educational institutions to offer internships and residency opportunities to their students in the areas of nursing, diagnostic imaging, rehabilitation services, laboratory, and pharmacy. In 2024, staff time spent in direct support of these programs included almost 3,000 hours for nursing, close to 5,000 hours for rehabilitation services and other allied health professions and 240 hours for physician assistant residencies, internships, and training. 2. Certified Nursing Program. Pending approval by the California Department of Public Health (CDPH), we are planning to participate in a 14-week guided study program for participants to become certified nursing assistants (CNA). The program is geared towards working adults and will be held during nights and weekends so they can continue to support themselves and their families. We are partnering with Vienna Nursing &amp; Rehab Center in Lodi to provide the training environment for participants and with California Preparatory College as our educational partner. We will need a minimum of 13 students to conduct the program. If the minimum is not met, we may also explore the possibility of including high school student participation because the CDPH allows youth as young as 16 to take the CNA licensing exam. As of December 2024, approval of the program by CDPH remained pending.3. AHLM has been awarded grant funding for a healthcare work-based learning project addressing the need for college and career readiness and the national healthcare worker shortage. The program, planned for a 2025 pilot at AHLM, will cultivate equitable engagement of high school and college students in San Joaquin, Merced, and Stanislaus Counties especially in rural and underserved communities. 4. Staff training was conducted in November 2024 to familiarize new leaders with the Unite Us platform's integration with the Adventist Health electronic medical record. This approach facilitates timely Unite Us referrals that are automatically recorded in the patient's hospital medical record and eliminates the need for dual entry. The team will integrate Unite Us into their discharge planning process moving forward, which will increase opportunities to support patients' access to services that address their health, social, and financial stability needs.Priority Need Three - Mental Health.The goal is to collaborate with community partners in addressing workplace related stress as well as mental health concerns that employees may have in the workplace through workplace symposiums addressing burnout prevention and available resources. Activities in 2024 included: In May 2024, AHLM provided free blood pressure tests, stress coping tips, and free COVID-19 testing kits at the Family Resource Center Child Caregiver Conference at San Joaquin County Agricultural Center. The event was developed to support child caregivers in the county who are typically self-employed with limited access to resources and services provided by employers. The event's focus was to support caregivers on stress management, mental health, and overall well-being. More than 400 childcare providers attended the event and interacted with our team on resources/support that AHLM makes available to the community.We utilized our Hospital's partnership with the American Heart Association to co-present educational outreach to the San Joaquin County workforce via their employers. This approach creates an incentive for employer participation by helping them maintain a healthy, productive workforce with reduced absenteeism. We conducted the in-person, "Mind, Heart, Body Symposium" at the Fairfield Inn in Lodi to help participants reduce stress, promote better sleep, and better regulate their emotions. The panel of speakers included an Adventist Health cardiology expert. This was open to employers and the general public; more than 60 people attended. We conducted an employers' onsite learning seminar on substance abuse that reached more than 1,000 employees. Finally, we conducted a second health webinar featuring an Adventist Health physician assistant for San Joaquin County employers on maintaining health during the holidays. More than 50 participants representing employers and community-based organizations throughout San Joaquin County participated.Significant needs not met:No hospital can address all the health needs identified in its community. AHLM is committed to serving the community by adhering to its mission, and using its skills, expertise, and resources to provide a range of community benefit programs. Significant health needs that will not be directly addressed include the following: housing, chronic disease and healthy eating, community safety, family and social support, education, and transportation. While these significant health needs are not address directly, they are likely to benefit from collective efforts of our community partnerships.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Section B, Line 13h:</FormAndLineReferenceDesc>
        <ExplanationTxt>Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources. The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>10</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - Lodi Outpatient Surgical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>521 S Ham Lane Suite F</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95242</ZIPCd>
          </USAddress>
          <FacilityTxt>Ambulatory surgical center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - AHLM Wound &amp; Hyperbaric Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2415 W Vine Street Suite 106</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95242</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient clinic - hyperbaric and wound care</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - Advanced Imaging Center at AHLM</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1031 S Fairmont Avenue</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95240</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient diagnostic imaging</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - Urgent Care Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1235 W Vine Street Suite 20</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95240</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient clinic - urgent care services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>5 - AHLM West Pharmacy</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2415 W Vine Street Suite 104 B</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95240</ZIPCd>
          </USAddress>
          <FacilityTxt>Retail pharmacy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>6 - Galt Family and Specialty Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>387 Civic Drive</AddressLine1Txt>
            <CityNm>Galt</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95632</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient clinic - family medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>7 - AHLM Occupational Medicine</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>800 S Lower Sacramento Road</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95242</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient clinic - occupational medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>8 - AHLM Adult Day Services</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>125 Hutchins Street Suite A</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95240</ZIPCd>
          </USAddress>
          <FacilityTxt>Adult/senior care day services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>9 - AHLM Prenatal Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2415 W Vine Street Suite 103</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95242</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient clinic - prenatal care</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>10 - Ham Lane Clinic - Fairmont Ave</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>845 S Fairmont Avenue Suite 8</AddressLine1Txt>
            <CityNm>Lodi</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>95240</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient clinic - cardiology and pulmonology</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on Hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (provision for bad debts + other revenue + interest income)/gross patient chargesThe Hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Community Building Activities:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options. 2024 saw continued transformation of our six community Blue Zones Projects through policy initiatives around built environment, tobacco use and food. Blue Zones widens our impact from only reaching our hospitals' communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the Hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Adventist Health audited combined financial statements do not contain a footnote describing bad debt expense.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Medicare Cost Report apportions the Hospital's costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever expanding regulatory requirements, shortages of highly skilled labor and involving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer.Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information, please refer to Schedule H, Part III, Section B.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>When a patient has requested screening for charity care, the Hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income, and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Adventist Lodi Memorial Hospital (AHLM) promotes access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in Tax Year 2023, and the Year Two Update, Tax Year 2024 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at: https://www.adventisthealth.org/lodi-memorial/about-us/community-benefit/The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2022, 2023 and 2024 Community Health Plan Updates are also available on the Adventist Health Corporate website at:https://www.adventisthealth.org/about-us/community-benefit/ The Community Health Needs Assessment (CHNA) includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health. Qualitative and quantitative data sources were used in conducting the CHNA. To accomplish the many important systemic goals that are underway in our community, Adventist Health supports local partners to augment our own efforts, and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of our region. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community. In addition to the CHNA, our Hospital engages in a process of continuous quality improvement, focusing on questions such as: are our interventions making a difference in improving health outcomes; are we providing the appropriate resources in the appropriate locations; and how are we using technology to track our health improvements and provide relevant feedback at the local level. Building a healthy community requires multiple stakeholders working together with a common purpose. With that in mind, our Hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness to the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the Hospital's website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the Hospital's Self-Pay Billing and Collection Policy is posted at: https://www.adventisthealth.org/documents/system/13863-self-pay-billing-and-collection-policy.pdfAt the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The Hospital also provides a brochure during the registration process that explains the Hospital's billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Near San Joaquin County, in the Central Valley of California, is roughly 60 miles east of San Francisco and 35 miles south of Sacramento, with a total population of 742,603 (2019). Historically, agriculture has been a strong driver of our economy and many migrants and immigrants have settled here to work in the fields and help with agricultural processing or shipping. The County is mostly rural, with one large urban core (Stockton) and seven smaller cities, as well as many ranching and farming communities scattered across the County.San Joaquin County is home to a high concentration of residents at elevated risk for COVID-19 and who have experienced enormous impacts from the pandemic. A quarter of residents are foreign-born. Overall, 14.5% of residents live in poverty. Residents aged 65 years and older have a poverty rate of 9.9%. The educational attainment of San Joaquin County residents is much lower than California residents. Only 18.8% of County residents aged 25 and older have a bachelor's degree or higher, compared to 33.9% of Californians aged 25 and older that have a bachelor's degree or higher. Many residents of San Joaquin County speak languages other than English at home. Over one quarter of San Joaquin County residents communicate at home in Spanish, which is less than the overall rate for California, and fewer County residents speak Chinese languages than California as a whole. A higher percentage of County residents speak Tagalog, Punjabi and Khmer as compared to California overall. San Joaquin County had higher (risk adjusted) rates of adult hospitalization for heart failure, COPD/asthma (ages 40-plus), asthma (ages 18-39) and hypertension in 2020 than California overall. Many of these hospitalizations could potentially be avoidable through access to high quality outpatient care. In San Joaquin County, the top five causes of death are heart disease, cancer, COVID-19, stroke and lung disease. According to 2021 County Health Profiles, out of 58 counties, San Joaquin County had the fourteenth highest death rate from diabetes, twenty-sixth highest coronary heart disease death rate, and the fifth highest stroke death rate in the state. The top five causes of death differ by race/ethnicity. Heart disease and cancer are among the top five causes of death for all racial/ethnic groups; diabetes is among the top five causes of death for Asian and Native Hawaiian/Pacific Islander residents, and unintentional injuries appears in the top five causes of death for Black/African American, Latinx (Hispanic), Native Hawaiian/Pacific Islander and multiethnic residents. COVID-19 was the number one cause of death for Asian and Latinx (Hispanic) residents.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Our Hospital's mission is, "Living God's love by inspiring health, wholeness and hope." Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the "Triple Aim." The "Triple Aim" concept broadly known and accepted within health care includes:1. Improve the experience of care for our residents.2. Improve the health of populations.3. Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low-income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given today's state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders.As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy.Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthy - even though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1. The distribution of specific health statuses and outcomes within a population, 2. Factors that cause the present outcomes distribution, and3. Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to:1. Increase the prevalence of evidence-based preventive health services and preventive health behaviors,2. Improve care quality and patient safety, and3. Advance care coordination across the health care continuum.We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as tele-pharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7, Reports Filed With States</FormAndLineReferenceDesc>
        <ExplanationTxt>CA</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI: Other Information:</FormAndLineReferenceDesc>
        <ExplanationTxt>Community benefit activities not included elsewhere are various events pertaining community health education in 2024. On March 17, AHLM participated in the World Kidney Day celebration at Desmesh Darbar Sikh Temple in Lodi. The purpose of the event was to raise awareness about kidney disease and promote overall community health. Activities included a blood drive, various medical and vision screenings, and health consultations. The AHLM team, comprised of six staff volunteers, encountered more than 400 people, provided more than 100 blood pressure tests and distributed 300 free COVID-19 home test kits.Every year, AHLM's Emergency Department supports community education at the Lodi Farmers' Market. On the evening of June 11, AHLM was featured as The Lodi Chamber of Commerce's "Business of the Week." Seven of our Emergency Department team members volunteered their time to educate community members on "Hands Only CPR." The AHLM Emergency Department team were able to train many Farmers' Market patrons in performing 30 or more CPR compressions, including officers from the Lodi Police Department who wanted to practice CPR. Many patrons were taking pictures and filming each other doing compressions. More than 250 people participated in this booth's activities.The AHLM Quality Management Services (QMS), Acute Physical Rehabilitation (APR), and Emergency Department (ED) teams partnered together to provide health education at The Lodi Farmers' Market. The team provided stroke education; including the BEFAST stroke protocol and the use of emergency medical services to get stroke victims to the hospital as soon as possible and within four hours from onset of symptoms. Our team provided resources outlining the stroke acute rehabilitation services offered by our Hospital and included child-friendly education with a Spin-to-Win Prize Wheel! More than 150 people participated in our booth's activities.</ExplanationTxt>
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          <StateAbbreviationCd>CA</StateAbbreviationCd>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Larsen David - Former</PersonNm>
        <TitleTxt>Finance Officer, CCR thru 04/19</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <OtherCompensationRltdOrgsAmt>573565</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>59142</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>632707</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Whitney Jason - Former</PersonNm>
        <TitleTxt>Treasurer/Asst Secr thru 08/22</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>394050</CompensationBasedOnRltdOrgsAmt>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>13296</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>66498</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>611644</TotalCompensationRltdOrgsAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Brown Mary</PersonNm>
        <TitleTxt>RN</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>6502</BonusFilingOrganizationAmount>
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        <DeferredCompensationFlngOrgAmt>24746</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>59500</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>582191</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Delmore Katie</PersonNm>
        <TitleTxt>Treasurer/Asst Secretary</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>315240</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <DeferredCompRltdOrgsAmt>13296</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>44489</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>497612</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Stewart Donovan</PersonNm>
        <TitleTxt>Patient Care Executive</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>340096</CompensationBasedOnRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>474802</TotalCompensationRltdOrgsAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Karagounis Timothy</PersonNm>
        <TitleTxt>Operations Excecutive</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>283716</CompensationBasedOnRltdOrgsAmt>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>13296</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>43133</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>442817</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sandhu Navneet</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <BaseCompensationFilingOrgAmt>268276</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1158</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>316599</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Marsh Kevin</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <BaseCompensationFilingOrgAmt>300480</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>311</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13296</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>314087</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Nguyen Tin</PersonNm>
        <TitleTxt>Director, Pharmacy</TitleTxt>
        <BaseCompensationFilingOrgAmt>240771</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>23657</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12039</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9431</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>285898</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Wing Bill - Former</PersonNm>
        <TitleTxt>Dir/Asst Secr/Vice Chair thru 01/22</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>273263</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>273263</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Pascua Helen</PersonNm>
        <TitleTxt>RN, First Assistant</TitleTxt>
        <BaseCompensationFilingOrgAmt>257477</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2945</OtherCompensationFilingOrgAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>260587</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Cornwell Eric - Former</PersonNm>
        <TitleTxt>Medical Officer thru 03/23</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <OtherCompensationRltdOrgsAmt>199641</OtherCompensationRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>23860</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>223501</TotalCompensationRltdOrgsAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Lines 4a-b</FormAndLineReferenceDesc>
        <ExplanationTxt>Severance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Cornwell, Eric - severance payment - $199,641 Jahn, Andrew - severance payment - $15,065 Larsen, David - severance payment - $567,118 Wing, Bill - severance payment - $271,535 Wolcott, Daniel - severance payment - $708,700 The Supplemental Executive Retirement Plan (SERP) is a defined contribution plan designed to encourage the participants continued employment with Adventist Health and is subject to the participants satisfying specified substantial risks of forfeiture. The SERP benefit distribution occurs when the executive achieves 30 years of Adventist health care service, 20 of which are to be as an executive and at least 10 are to be with Adventist Health System/West, and reaches age 60. Until that time, the SERP benefit is at risk to the creditors of Adventist Health. The SERP benefit is designed to help the executive receive employer-provided retirement benefit income equal to 60% of pre-retirement income. The SERP plan was frozen for new participants in 2016. Larsen, David - participant, no activity in 2023 Select executives agreed to participate in CAP-EX in place of a traditional insurance SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Jack Wagner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2023</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4a:</FormAndLineReferenceDesc>
        <ExplanationTxt>Lodi Memorial Hospital Association, Inc., DBA Adventist Health Lodi Memorial (AHLM), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. AHLM, located in San Joaquin County, is one of the region's premier nonprofit healthcare providers that encompasses a hospital, medical practice locations, and wellness programs. Specialty services offered include cardiology, endocrinology, gastroenterology, neurology, occupational medicine, oncology, outpatient therapy services, pediatrics, prenatal, pulmonology, surgical care, wound care, and hyperbaric medicine. The Adventist Health Lodi network has expanded extensively to now include five primary care medical practices, a free outreach clinic, and 10 specialty medical practices. In 2021, AHLM opened a Cancer Care Clinic, offering state-of-the-art, comprehensive cancer care to the community. Although reimbursement for services rendered is critical to the operation and stability of AHLM, the organization recognizes that not all individuals possess the ability to pay for essential medical services. Adventist Health's vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following coverage will be considered when individuals who need health care cannot afford to pay: - Free care and/or subsidized care - Care to persons covered by governmental programs at/or below cost - Health/wellness activities and community education programs Not only does AHLM provide low-cost care to individuals covered by government programs, and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits. AHLM recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2024 was $551,862. The following services were provided to all our patients: - 198,710 clinic visits - 829 deliveries - 7,905 discharges - 61,436 emergency room visits - 1,261 inpatient surgeries - 87,048 outpatient hospital visits - 4,668 outpatient surgeries - 34,206 patient days AHLM recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Schedule H provides more details on the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2024 was $24,231,590. AHLM's quality and performance awards include: SRC designated Center of Excellence for Robotic Surgery, Orthopedic Surgery, Minimally Invasive Surgery and Gynecology, American Heart Association's 2024 Get With The Guidelines Stroke Gold Plus Award and BP Gold Plus Award, Healthgrades Five-Star ratings for Hip Fracture Treatment and Treatment of Diabetic Emergencies, Geriatric Emergency Department Accreditation from the American College of Emergency Physicians, 2022 Premier QUEST Award for High-value Healthcare, International Designation of "Baby- Friendly Hospital" by Baby-Friendly USA, Ranked top 10% of national inpatient rehabilitation facilities. Adventist Health's mission statement of living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital's Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors of the Hospital shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital does not have any Members.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the Corporate Finance Officer and Market Financial Officer, and shared by electronic communication with the Corporation's Board of Directors prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital corporate officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president or the System Chief Legal Officer/General Counsel immediately. The System Chief Legal Officer/General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the Hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System Chief Legal Officer/General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System Chief Legal Officer/General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The Adventist Health Board of Directors has established an Executive Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 40 percent spread from minimum to maximum.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VII:</FormAndLineReferenceDesc>
        <ExplanationTxt>Board compensation is for Adventist Health System/West Board of Directors only - not Hospital Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Physician fees: Program service expenses 18,592,446. Management and general expenses 193,321. Fundraising expenses 0. Total expenses 18,785,767. Other medical professional fees: Program service expenses 1,440. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,440. Contract labor: Program service expenses 9,615,489. Management and general expenses 137,040. Fundraising expenses 0. Total expenses 9,752,529. All other purchased services: Program service expenses 2,655,413. Management and general expenses 336,738. Fundraising expenses 0. Total expenses 2,992,151. Purchased medical services: Program service expenses 6,253,802. Management and general expenses 76,945. Fundraising expenses 0. Total expenses 6,330,747. Consulting fees: Program service expenses 1,235,048. Management and general expenses 231,528. Fundraising expenses 0. Total expenses 1,466,576. Repairs and maintenance: Program service expenses 3,161,148. Management and general expenses 944,240. Fundraising expenses 0. Total expenses 4,105,388. Other professional fees non-medical: Program service expenses 9,603. Management and general expenses 43,561. Fundraising expenses 0. Total expenses 53,164.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in investment in subsidiaries -7,387. Asset cost adjustment 63.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>Prior period adjustments were a result of cash balance correction and clean up books due to prior period activities including debt service, capital expenditures, and other items.</ExplanationTxt>
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          <CityNm>Sonora</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95370</ZIPCd>
        </USAddress>
        <EIN>941415069</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Adventist Health SystemWest</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Stone Point Health</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Adventist Health Way</AddressLine1Txt>
          <CityNm>Roseville</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95661</ZIPCd>
        </USAddress>
        <EIN>823763347</EIN>
        <PrimaryActivitiesTxt>Supporting organization</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Adventist Health SystemWest</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Twin Cities Community Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1100 Las Tablas Road</AddressLine1Txt>
          <CityNm>Templeton</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93465</ZIPCd>
        </USAddress>
        <EIN>752918765</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Adventist Health SystemWest</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Ukiah Adventist Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>275 Hospital Drive</AddressLine1Txt>
          <CityNm>Ukiah</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95482</ZIPCd>
        </USAddress>
        <EIN>941639901</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Adventist Health SystemWest</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>United Com-Serve</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>726 Fourth Street</AddressLine1Txt>
          <CityNm>Marysville</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95901</ZIPCd>
        </USAddress>
        <EIN>943015356</EIN>
        <PrimaryActivitiesTxt>Skilled nursing/assisted living/home health</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Stone Point Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Western Health Resources</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Adventist Health Way</AddressLine1Txt>
          <CityNm>Roseville</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95661</ZIPCd>
        </USAddress>
        <EIN>953867863</EIN>
        <PrimaryActivitiesTxt>Home care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Adventist Health SystemWest</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>White Memorial Medical Center</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1720 E Cesar E Chavez Avenue</AddressLine1Txt>
          <CityNm>Los Angeles</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>90033</ZIPCd>
        </USAddress>
        <EIN>952282647</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Adventist Health SystemWest</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Willits Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Marcela Drive</AddressLine1Txt>
          <CityNm>Willits</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95490</ZIPCd>
        </USAddress>
        <EIN>680108919</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Adventist Health SystemWest</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Advanced Imaging Center at Lodi Memorial Hospital LLC (AIC)</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1001 S Fairmont Avenue</AddressLine1Txt>
          <CityNm>Lodi</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95240</ZIPCd>
        </USAddress>
        <EIN>943407786</EIN>
        <PrimaryActivitiesTxt>Diagnostic imaging / MRI outpatient treatment center</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Lodi Memorial Hospital Association Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>586185</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>5531255</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
        <OwnershipPct>1.00000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Blue Legacy Ventures LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1010 NE 2nd Avenue</AddressLine1Txt>
          <CityNm>Miami</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33132</ZIPCd>
        </USAddress>
        <EIN>871254649</EIN>
        <PrimaryActivitiesTxt>Real property rental</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>FL</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Blue Zones LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>200 Southdale Center</AddressLine1Txt>
          <CityNm>Edina</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55435</ZIPCd>
        </USAddress>
        <EIN>271603327</EIN>
        <PrimaryActivitiesTxt>Education</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PAR LLC DBA CherryWood Village</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>8440 SE Sunnybrook Blvd Suite 100</AddressLine1Txt>
          <CityNm>Clackmas</CityNm>
          <StateAbbreviationCd>OR</StateAbbreviationCd>
          <ZIPCd>97015</ZIPCd>
        </USAddress>
        <EIN>931262371</EIN>
        <PrimaryActivitiesTxt>Senior housing</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OR</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PVHR LLC DBA Paradise Village</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>8440 SE Sunnybrook Blvd Suite 100</AddressLine1Txt>
          <CityNm>Clackmas</CityNm>
          <StateAbbreviationCd>OR</StateAbbreviationCd>
          <ZIPCd>97015</ZIPCd>
        </USAddress>
        <EIN>260622555</EIN>
        <PrimaryActivitiesTxt>Senior housing</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OR</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PVHR2 LLC DBA Parkview Memory Care at Paradise Village</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>8440 SE Sunnybrook Blvd Suite 100</AddressLine1Txt>
          <CityNm>Clackmas</CityNm>
          <StateAbbreviationCd>OR</StateAbbreviationCd>
          <ZIPCd>97015</ZIPCd>
        </USAddress>
        <EIN>473300170</EIN>
        <PrimaryActivitiesTxt>Senior housing</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OR</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>WWGHR LLC DBA Wheatland Village</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>8440 SE Sunnybrook Blvd Suite 100</AddressLine1Txt>
          <CityNm>Clackmas</CityNm>
          <StateAbbreviationCd>OR</StateAbbreviationCd>
          <ZIPCd>97015</ZIPCd>
        </USAddress>
        <EIN>810591221</EIN>
        <PrimaryActivitiesTxt>Senior housing</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OR</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Delta Radiology Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>975 S Fairmont Avenue</AddressLine1Txt>
          <CityNm>Lodi</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95240</ZIPCd>
        </USAddress>
        <EIN>941715690</EIN>
        <PrimaryActivitiesTxt>Radiology services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Lodi Regional Health Systems Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>4824996</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>8437059</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Lodi Regional Health Systems Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>975 S Fairmont Avenue</AddressLine1Txt>
          <CityNm>Lodi</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95240</ZIPCd>
        </USAddress>
        <EIN>680398894</EIN>
        <PrimaryActivitiesTxt>Physician management and medical office building development &amp; management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Lodi Memorial Hospital Association Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>5988756</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>17942834</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>AdHealth Limited</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>PO Box HM 2062</AddressLine1Txt>
          <CityNm>Hamilton</CityNm>
          <CountryCd>BD</CountryCd>
          <ForeignPostalCd>HM HX</ForeignPostalCd>
        </ForeignAddress>
        <PrimaryActivitiesTxt>Pure captive insurance</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>BD</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Adventist Health Plan Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Adventist Health Way</AddressLine1Txt>
          <CityNm>Roseville</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95661</ZIPCd>
        </USAddress>
        <EIN>463833261</EIN>
        <PrimaryActivitiesTxt>Health insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>South Coast Medical Center</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Adventist Health Way</AddressLine1Txt>
          <CityNm>Roseville</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>95661</ZIPCd>
        </USAddress>
        <EIN>952037291</EIN>
        <PrimaryActivitiesTxt>Wind down after sale of hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Thrive Productions Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>200 Southdale Center</AddressLine1Txt>
          <CityNm>Edina</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55435</ZIPCd>
        </USAddress>
        <EIN>453369049</EIN>
        <PrimaryActivitiesTxt>Production company</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>1</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>1</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>1</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Advanced Imaging Center at Lodi Memorial Hospital LLC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>9639</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Advanced Imaging Center at Lodi Memorial Hospital LLC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>882536</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Lodi Regional Health Systems Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>224017</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Delta Rediology Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>1024816</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>