﻿<?xml version="1.0" encoding="utf-8"?>
<Return returnVersion="2019v5.0" xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2020-10-31T19:57:16-07:00</ReturnTs>
    <TaxPeriodEndDt>2019-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>472251777</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CHW LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>7797 N First Street Suite 15</AddressLine1Txt>
        <CityNm>Fresno</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>93720</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2019-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>200517238</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Sante Health Foundation</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>SANT</BusinessNameControlTxt>
      <PhoneNum>5592285451</PhoneNum>
      <USAddress>
        <AddressLine1Txt>7370 North Palm Avenue Suite 101</AddressLine1Txt>
        <CityNm>Fresno</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>93711</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Mateo DeSoto</PersonNm>
      <PersonTitleTxt>Chairperson</PersonTitleTxt>
      <PhoneNum>5592285400</PhoneNum>
      <SignatureDt>2020-09-03</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Jeremy Ware</PreparerPersonNm>
      <PTIN>P00642659</PTIN>
      <PhoneNum>5595495400</PhoneNum>
      <PreparationDt>2020-08-30</PreparationDt>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>172.58.35.21</IPv4AddressTxt>
      </IPAddress>
    </FilingSecurityInformation>
    <TaxYr>2019</TaxYr>
    <BuildTS>2021-01-29 14:40:06Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="R000001" referenceDocumentId="R000007" softwareId="19009572" softwareVersionNum="v1.00">
      <PrincipalOfficerNm>Scott Wells</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>7370 North Palm Avenue</AddressLine1Txt>
        <CityNm>Fresno</CityNm>
        <StateAbbreviationCd>CA</StateAbbreviationCd>
        <ZIPCd>93711</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>252417976</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.santehealthfoundation.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2003</FormationYr>
      <LegalDomicileStateCd>CA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Santé Health Foundation's mission is to provide medical care and treatment as part of a coordinated healthcare delivery system in the Central Valley. The Foundation provides these services for preventing, treating and otherwise assisting individuals with various diseases and disorders to the extent reasonably permitted by the resources of the Foundation. The medical Foundation provides these services through charity care assistance for patients meeting certain financial eligibility and clinical criteria and persons without insurance or who are under insured, all self-paid, uninsured and under insured patients who do not qualify for charity care under the Foundation's Charity Care Program are offered services through the Foundation at discounted charges. The discount is extended to patients that qualify for the Foundation's Charity Care Program for the out-of-pocket portions of care that are beyond the amount the patient qualified for the Foundation's subsidized care.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>7</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>7</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>26405002</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>45339419</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>162780635</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>203429795</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>0</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>0</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>3086949</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>3648762</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>192272586</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>252417976</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>24128828</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>25393564</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>0</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>0</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>288526</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>167994323</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>208755757</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>192123151</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>234149321</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>149435</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>18268655</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>46964284</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>40928703</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>45906744</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>21602508</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>1057540</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>19326195</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>Santé Health Foundation's mission is to provide medical care and treatment as part of a coordinated healthcare delivery system in the Central Valley. The Foundation provides these services for preventing, treating and otherwise assisting individuals with various diseases and disorders to the extent reasonably permitted by the resources of the Foundation.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>231738244</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>203429795</RevenueAmt>
      <Desc>Santé Health Foundation's mission is to provide medical care and treatment as part of a coordinated healthcare delivery system in the Central Valley. The Foundation provides these services for preventing, treating and otherwise assisting individuals with various diseases and disorders to the extent reasonably permitted by the resources of the Foundation. The medical Foundation provides these services through charity care assistance for patients meeting certain financial eligibility and clinical criteria and persons without insurance or who are under insured, all self-paid, uninsured and under insured patients who do not qualify for charity care under the Foundation's Charity Care Program are offered services through the Foundation at discounted charges. The discount is extended to patients that qualify for the Foundation's Charity Care Program for the out-of-pocket portions of care that are beyond the amount the patient qualified for the Foundation's subsidized care. The Foundation was also formed to conduct or participate in medical and scientific investigations and researches into various diseases and to promote and carry on educational activities related to the health and well-being of the sick, injured and disabled. The Foundation is part of an integrated system that combines medical research activities directly with patient care in both in-patient and out-patient settings. The Foundation also provides or arranges for the provision of certain patient care and on-call coverage services and research, teaching and administrative services to the Central Valley. Through clinics and various agreements, the Foundation is able to insure that patient care as well as accompanying clinical research and community education is provided seamlessly through an integrated network of providers. The Foundation also provides or arranges for the provision of care for vulnerable populations including Medicare and Medi-Cal beneficiaries and charity care patients. Care is made available to beneficiaries of these programs on a non-discriminatory basis within its out-patient facilities. The Foundation also makes investments in community benefit activities.</Desc>
      <TotalOtherProgSrvcExpenseAmt>0</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>0</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>0</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>231738244</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="R000002">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="R000003">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd>0</DonorAdvisedFundInd>
      <ConservationEasementsInd>0</ConservationEasementsInd>
      <CollectionsOfArtInd>0</CollectionsOfArtInd>
      <CreditCounselingInd>0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="R000004">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="R000004">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd>0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="R000004">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="R000004">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="R000004">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="R000005">1</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="R000006">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>0</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>13</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>7</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>7</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>CA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>Scott Wells</PersonNm>
        <PhoneNum>5592285400</PhoneNum>
        <USAddress>
          <AddressLine1Txt>7370 North Palm Avenue Suite 101</AddressLine1Txt>
          <CityNm>Fresno</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93711</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mateo DeSoto</PersonNm>
        <TitleTxt>Chairperson</TitleTxt>
        <AverageHoursPerWeekRt>2</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Randall Stern</PersonNm>
        <TitleTxt>Vice Chairperson</TitleTxt>
        <AverageHoursPerWeekRt>2</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Grant Nakamura</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>2</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kevin Follansbee</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>2</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Linzie Daniel</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tim Joslin</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Patrick Wymore</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Community Foundation Medical Group</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1180 East Shaw Avenue</AddressLine1Txt>
            <CityNm>Fresno</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93710</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Accounts Receivable Collections</ServicesDesc>
        <CompensationAmt>211433835</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Physician Network Advantage</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>7255 North First Street</AddressLine1Txt>
            <CityNm>Fresno</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93720</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EMR Software Services</ServicesDesc>
        <CompensationAmt>1495595</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Sante Health System</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>7370 North Palm Avenue Suite 101</AddressLine1Txt>
            <CityNm>Fresno</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93711</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Admin Services</ServicesDesc>
        <CompensationAmt>3007599</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>CDW Government</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>75 Remitance Drive</AddressLine1Txt>
            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60675</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Computer Hardware</ServicesDesc>
        <CompensationAmt>195767</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Woodruff Sawyer</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 45057</AddressLine1Txt>
            <CityNm>San Francisco</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>94145</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Insurance</ServicesDesc>
        <CompensationAmt>178283</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>229449</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>0</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>45109970</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>45339419</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Net patient service revenue</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>203429795</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>203429795</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>203429795</TotalProgramServiceRevenueAmt>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>3648762</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3648762</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>3648762</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>252417976</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>207078557</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>25393564</TotalAmt>
        <ProgramServicesAmt>25393564</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </CompCurrentOfcrDirectorsGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>205871205</TotalAmt>
        <ProgramServicesAmt>204037873</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1833332</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>6220</TotalAmt>
        <ManagementAndGeneralAmt>6220</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <InformationTechnologyGrp>
        <TotalAmt>1982955</TotalAmt>
        <ProgramServicesAmt>1982955</ProgramServicesAmt>
      </InformationTechnologyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>89528</TotalAmt>
        <ProgramServicesAmt>89528</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>80810</TotalAmt>
        <ProgramServicesAmt>80810</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>153514</TotalAmt>
        <ProgramServicesAmt>153514</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>162987</TotalAmt>
        <ManagementAndGeneralAmt>162987</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>408538</TotalAmt>
        <ManagementAndGeneralAmt>120012</ManagementAndGeneralAmt>
        <FundraisingAmt>288526</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>234149321</TotalAmt>
        <ProgramServicesAmt>231738244</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2122551</ManagementAndGeneralAmt>
        <FundraisingAmt>288526</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>4760106</BOYAmt>
        <EOYAmt>3750710</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>289714</BOYAmt>
        <EOYAmt>521350</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>17944555</BOYAmt>
        <EOYAmt>16186635</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>2314558</BOYAmt>
        <EOYAmt>2062264</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>110164</BOYAmt>
        <EOYAmt>158168</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>2298626</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2098720</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>239869</BOYAmt>
        <EOYAmt>199906</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>21305318</BOYAmt>
        <EOYAmt>18049670</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>46964284</BOYAmt>
        <EOYAmt>40928703</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>20606775</BOYAmt>
        <EOYAmt>18781709</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>23506023</BOYAmt>
        <EOYAmt>1445000</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>1793946</BOYAmt>
        <EOYAmt>1375799</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>45906744</BOYAmt>
        <EOYAmt>21602508</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>1057540</BOYAmt>
        <EOYAmt>1178792</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>18147403</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>1057540</BOYAmt>
        <EOYAmt>19326195</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>46964284</BOYAmt>
        <EOYAmt>40928703</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>18268655</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>0</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>0</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="R000002" softwareId="19009572" softwareVersionNum="v1.00">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>14703980</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>21404168</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27490671</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>264050020</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>251431895</CurrentTaxYearAmt>
        <TotalAmt>579080734</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>14703980</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>21404168</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27490671</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>264050020</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>251431895</CurrentTaxYearAmt>
        <TotalAmt>579080734</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>579080734</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>9373</CurrentTaxYearMinus4YearsAmt>
        <TotalAmt>9373</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>5510</CurrentTaxYearMinus4YearsAmt>
        <TotalAmt>5510</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>579095617</TotalSupportAmt>
      <PublicSupportCY170Pct>0.99997</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99996</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part II, Line 10</FormAndLineReferenceDesc>
        <ExplanationTxt>Other revenue</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="R000003" softwareId="19009572" softwareVersionNum="v1.00">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="R000004" softwareId="19009572" softwareVersionNum="v1.00">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <BookValueAmt>0</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>2298626</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2098720</DepreciationAmt>
        <BookValueAmt>199906</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>199906</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Restricted Cash</Desc>
        <BookValueAmt>18049670</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>18049670</TotalBookValueOtherAssetsAmt>
      <TotalLiabilityAmt>0</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>252417976</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>0</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <RecoveriesPriorYearGrantsAmt>0</RecoveriesPriorYearGrantsAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>252417976</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>0</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>252417976</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>234149321</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>0</DonatedServicesUseFcltsAmt>
      <PriorYearAdjustmentsAmt>0</PriorYearAdjustmentsAmt>
      <LossesReportedAmt>0</LossesReportedAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>234149321</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>0</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>234149321</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>SHF is a not-for-profit corporation and has been recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Revenue Code and by the California Franchise Tax Board pursuant to Section 23701(d) of the Revenue and Taxation Code. The IRS has determined that SHF is a public charity under the Revenue and Taxation Code. Accordingly, no provision for income taxes is included in the accompanying financial statements. SHF's returns are subject to examination by federal and state taxing authorities generally for three years after they are filed.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="R000005" softwareId="19009572" softwareVersionNum="v1.00">
      <FundraisingEventInformationGrp>
        <Event1Nm>Annual Gala</Event1Nm>
        <GrossReceiptsEvent1Amt>517615</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>0</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>517615</GrossRevenueEvent1Amt>
        <CashPrizesEvent1Amt>0</CashPrizesEvent1Amt>
        <NonCashPrizesEvent1Amt>0</NonCashPrizesEvent1Amt>
        <RentFacilityCostsEvent1Amt>0</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>0</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>0</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>288566</OtherDirectExpensesEvent1Amt>
        <FoodAndBeverageOtherEventsAmt>0</FoodAndBeverageOtherEventsAmt>
        <EntertainmentOtherEventsAmt>0</EntertainmentOtherEventsAmt>
        <GrossReceiptsTotalAmt>517615</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>0</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>517615</GrossRevenueTotalEventsAmt>
        <CashPrizesTotalEventsAmt>0</CashPrizesTotalEventsAmt>
        <NonCashPrizesTotalEventsAmt>0</NonCashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>0</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>0</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>0</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>288566</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>288566</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>229049</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleI documentId="R000006" softwareId="19009572" softwareVersionNum="v1.00">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Community Foundation Medical Group</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>7370 N Palm Avenue</AddressLine1Txt>
          <AddressLine2Txt>Suite 1010</AddressLine2Txt>
          <CityNm>Fresno</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93711</ZIPCd>
        </USAddress>
        <RecipientEIN>270271872</RecipientEIN>
        <CashGrantAmt>25281418</CashGrantAmt>
        <NonCashAssistanceAmt>2136469</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Purchase price</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>EMR System</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>To setup clinics to provide program medical services.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Family Healthcare Network</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>305 E Center Avenue</AddressLine1Txt>
          <CityNm>Visalia</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93291</ZIPCd>
        </USAddress>
        <RecipientEIN>942525145</RecipientEIN>
        <IRCSectionDesc>501 c 3</IRCSectionDesc>
        <CashGrantAmt>100000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>0</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>Support program service activities.</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>2</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Reporting required as part of grant monitoring.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="R000007" softwareId="19009572" softwareVersionNum="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part I, Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Current year activity was $25,941,078, which is in line with and comparable to prior years totals for Contributions and Grants, Line 8. Addtional activity was a result of adoption of recently adopted accounting standards, specifically related to donor restricted net assets and deferred revenue.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization works with an independent CPA to prepare the 990 return, a copy of the return is made available to board members prior to filing, which is noted in the meeting minutes of the board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Compliance is monitored on an as needed basis.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>