﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xsi:schemaLocation="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2019v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2020-11-04T16:12:30-06:00</ReturnTs>
    <TaxPeriodEndDt>2019-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmName>
        <BusinessNameLine1Txt>STOCKMAN KAST RYAN &amp; CO LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>102 N CASCADE AVENUE SUITE 400</AddressLine1Txt>
        <CityNm>COLORADO SPRINGS</CityNm>
        <StateAbbreviationCd>CO</StateAbbreviationCd>
        <ZIPCd>80903</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2019-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>840617567</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>PEAK VISTA COMMUNITY HEALTH CENTERS</BusinessNameLine1Txt>
      </BusinessName>
      <InCareOfNm>% PEAK VISTA CHC</InCareOfNm>
      <BusinessNameControlTxt>PEAK</BusinessNameControlTxt>
      <PhoneNum>7193446188</PhoneNum>
      <USAddress>
        <AddressLine1Txt>3205 N ACADEMY BLVD STE 130</AddressLine1Txt>
        <CityNm>COLORADO SPRINGS</CityNm>
        <StateAbbreviationCd>CO</StateAbbreviationCd>
        <ZIPCd>80917</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>ROBIN JOHNSON MD</PersonNm>
      <PersonTitleTxt>CHAIRPERSON</PersonTitleTxt>
      <PhoneNum>7193443188</PhoneNum>
      <SignatureDt>2020-11-15</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>DOREEN B MERZ</PreparerPersonNm>
      <PTIN>P00841439</PTIN>
      <PhoneNum>7196301186</PhoneNum>
      <PreparationDt>2020-11-15</PreparationDt>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>75.70.12.90</IPv4AddressTxt>
      </IPAddress>
      <FederalOriginalSubmissionId>84355620203095000002</FederalOriginalSubmissionId>
      <FederalOriginalSubmissionIdDt>2020-11-04</FederalOriginalSubmissionIdDt>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>C247C5DE291C000F0B9A307014B4EB6C1E631328</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>61CC2C3966234FF4F4EA70F7A9F54DE454C1E9B1</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2019</TaxYr>
    <BuildTS>2021-01-29 14:40:06Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="11">
    <IRS990 documentId="IRS990" referenceDocumentId="IRS990ScheduleO">
      <PrincipalOfficerNm>ROBIN JOHNSON MD</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>3205 N ACADEMY BLVD STE 130</AddressLine1Txt>
        <CityNm>CO SPGS</CityNm>
        <StateAbbreviationCd>CO</StateAbbreviationCd>
        <ZIPCd>80917</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>98935936</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.peakvista.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1971</FormationYr>
      <LegalDomicileStateCd>CO</LegalDomicileStateCd>
      <ActivityOrMissionDesc>To provide exceptional healthcare to people facing access barriers through clinical programs and education.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>11</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>1311</TotalEmployeeCnt>
      <TotalVolunteersCnt>73</TotalVolunteersCnt>
      <TotalGrossUBIAmt>17058</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>16248038</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>18424811</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>68087126</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>69054110</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>303805</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>516816</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>9720848</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>10524738</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>94359817</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>98520475</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>67119175</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>72021945</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>544248</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>24269731</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>25553801</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>91388906</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>97575746</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>2970911</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>944729</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>81423199</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>82098732</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>20456841</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>19919181</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>60966358</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>62179551</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TO PROVIDE EXCEPTIONAL HEALTHCARE TO PEOPLE FACING ACCESS BARRIERS THROUGH CLINICAL PROGRAMS AND EDUCATION, SERVING OVER 93,000 PEOPLE LIVING IN THE PIKES PEAK AND EAST CENTRAL REGIONS OF COLORADO THROUGH 27 HEALTH CENTERS SPREAD ACROSS 20 SERVICE LOCATIONS.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>70645217</ExpenseAmt>
      <RevenueAmt>61328149</RevenueAmt>
      <Desc>Primary Care: Peak Vista served 93,387 patients with 352,887 total visits in 2019. Additionally, through our Primary Care Program, Peak Vista provided care coordination and support services for 77,965 visits, 25,649 visits associated with our Behavioral Health Services and 1,930 visits through our Volunteer Specialty Care Center. CONTINUED ON SCH O</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>9236537</ExpenseAmt>
        <RevenueAmt>7187457</RevenueAmt>
        <Desc>Dental: Peak Vista served dental patients in 2019 with 35,824 visits. Dental visits occur in Family Health Centers and our Main Dental Center. Dental hygienist services are also integrated into our Pediatric Health Centers.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>1689475</ExpenseAmt>
        <RevenueAmt>731665</RevenueAmt>
        <Desc>Homeless: The Homeless program provides primary medical, dental care, and integrated behavioral health care. Peak Vista served 1,649 patients though 1,824 visits in 2019. Our homeless services are located adjacent to community partners to better serve those experiencing homelessness.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <RevenueAmt>10096182</RevenueAmt>
        <Desc>Prescription Agreement Fees</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <ProgSrvcAccomActyOtherGrp>
        <RevenueAmt>139959</RevenueAmt>
        <Desc>Other</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcRevenueAmt>10236141</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>81571229</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="IRS990ScheduleC">false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="IRS990ScheduleC">true</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="IRS990ScheduleC">false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="IRS990ScheduleD">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="IRS990ScheduleD">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="IRS990ScheduleD">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="IRS990ScheduleD">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="IRS990ScheduleD">true</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentId="IRS990ScheduleG">false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="IRS990ScheduleG">true</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentId="IRS990ScheduleG">false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="IRS990ScheduleK">true</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>false</InvestTaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="IRS990ScheduleM">true</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="IRS990ScheduleM">false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="IRS990ScheduleR">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="IRS990ScheduleR">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>true</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="IRS990ScheduleR">true</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="IRS990ScheduleR">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="IRS990ScheduleR">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>101</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>1311</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>true</Form990TFiledInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>true</QuidProQuoContributionsInd>
      <QuidProQuoContriDisclInd>true</QuidProQuoContriDisclInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>11</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>CO</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>PEAK VISTA CHC</PersonNm>
        <PhoneNum>7193446188</PhoneNum>
        <USAddress>
          <AddressLine1Txt>3205 N ACADEMY BLVDSTE 130</AddressLine1Txt>
          <CityNm>CO SPGS</CityNm>
          <StateAbbreviationCd>CO</StateAbbreviationCd>
          <ZIPCd>80917</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <InfoInScheduleOPartVIIInd>X</InfoInScheduleOPartVIIInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>Peter A Liehr</PersonNm>
        <TitleTxt>OB GYN Provider</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>426970</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27538</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jeffrey D McCutcheon</PersonNm>
        <TitleTxt>Director Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>404367</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27538</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Catharine Roos</PersonNm>
        <TitleTxt>OB GYN Provider</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>337539</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21015</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Pamela McManus</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>300538</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21613</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Amy Clauss</PersonNm>
        <TitleTxt>OB GYN Provider</TitleTxt>
        <AverageHoursPerWeekRt>35.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>304396</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12043</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Darvi C Rahaman</PersonNm>
        <TitleTxt>VP of Medical</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>244495</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26121</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lisa Ramey</PersonNm>
        <TitleTxt>Chief Medical &amp; Dental Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>257263</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11136</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Scott Robinson</PersonNm>
        <TitleTxt>VP of Medical</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>251339</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10056</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Timothy Brininger Ter</PersonNm>
        <TitleTxt>OB GYN Provider</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>238004</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8248</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Karen C Campbell Munch</PersonNm>
        <TitleTxt>VP of Medical</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>222053</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19082</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tracy Narvet</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>200291</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16118</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Richard Leensvaart</PersonNm>
        <TitleTxt>VP of Dental</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>192068</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18090</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Michael Welch Retired</PersonNm>
        <TitleTxt>Chief Medical &amp; Dental Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>191579</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8584</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Louie Larimer Term 05</PersonNm>
        <TitleTxt>Chief Strategy Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>180209</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12607</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Colette Martin</PersonNm>
        <TitleTxt>Chief Strategy Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>105073</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5099</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Nartker</PersonNm>
        <TitleTxt>Chief Operations Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>82084</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5411</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Robin Johnson</PersonNm>
        <TitleTxt>Board Chairperson</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Victoria Stone</PersonNm>
        <TitleTxt>Vice Chairperson</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Bill Sanden</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rev Clifton Turner</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Santiago Duran</PersonNm>
        <TitleTxt>Board Member at large</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Marianne Horvath</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Ray Nunn</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mary Lynn Sheetz</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dennis Smialek DVM</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Pam Taylor</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rodrigo Villazon</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3938268</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>250299</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>116</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>CALL 4 HEALTHNURSE</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4720 NW BOCA RATON BLVD SUITE D105</AddressLine1Txt>
            <CityNm>BOCA RATON</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>33431</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CALL-IN NURSE/TRIAGE</ServicesDesc>
        <CompensationAmt>189401</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>BARTON ASSOCIATES</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>10 DEARBORN ROAD</AddressLine1Txt>
            <CityNm>PEABODY</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01960</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LOCUM TENENS</ServicesDesc>
        <CompensationAmt>307861</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>UNIVERSAL PROTECTION SERVICE LP</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1551 N TUSTIN AVE SUITE 650</AddressLine1Txt>
            <CityNm>SANTA ANA</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92705</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SECURITY SERVICES</ServicesDesc>
        <CompensationAmt>272512</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>OSIS INC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>8790 Governors Hill Drive Ste 202</AddressLine1Txt>
            <CityNm>CINCINNATI</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45249</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Software lic/maint</ServicesDesc>
        <CompensationAmt>1230090</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Brightview Landscapes</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 31001-2463</AddressLine1Txt>
            <CityNm>PASADENA</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>91110</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Grounds Maintenance</ServicesDesc>
        <CompensationAmt>256043</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <FundraisingAmt>12931</FundraisingAmt>
      <GovernmentGrantsAmt>10469084</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>7942796</AllOtherContributionsAmt>
      <NoncashContributionsAmt>3783067</NoncashContributionsAmt>
      <TotalContributionsAmt>18424811</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE/MEDICAID</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>46694734</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>46694734</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT FEES</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>10099529</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10099529</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>TOBACCO REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>2226278</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2226278</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>COLORADO INDIGENT CARE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>986545</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>986545</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>9047024</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9047024</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>69054110</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>544700</TotalRevenueColumnAmt>
        <ExclusionAmt>544700</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>277816</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>242710</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>35106</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>35106</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>18048</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>17058</UnrelatedBusinessRevenueAmt>
      </NetRentalIncomeOrLossGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>27884</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>-27884</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-27884</TotalRevenueColumnAmt>
        <ExclusionAmt>-27884</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>223245</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>12931</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>144867</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>78378</TotalRevenueColumnAmt>
        <ExclusionAmt>78378</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>PRESCRIPTION AGREEMENT FEES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>10096182</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10096182</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISC</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>315072</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>315072</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>10411254</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>98520475</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>79483412</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>17058</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>595194</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2566463</TotalAmt>
        <ProgramServicesAmt>2228625</ProgramServicesAmt>
        <ManagementAndGeneralAmt>318956</ManagementAndGeneralAmt>
        <FundraisingAmt>18882</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>55792659</TotalAmt>
        <ProgramServicesAmt>48448344</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6933827</ManagementAndGeneralAmt>
        <FundraisingAmt>410488</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1505789</TotalAmt>
        <ProgramServicesAmt>1318896</ProgramServicesAmt>
        <ManagementAndGeneralAmt>173476</ManagementAndGeneralAmt>
        <FundraisingAmt>13417</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>8047218</TotalAmt>
        <ProgramServicesAmt>6517501</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1482480</ManagementAndGeneralAmt>
        <FundraisingAmt>47237</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>4109816</TotalAmt>
        <ProgramServicesAmt>3554327</ProgramServicesAmt>
        <ManagementAndGeneralAmt>522934</ManagementAndGeneralAmt>
        <FundraisingAmt>32555</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>246555</TotalAmt>
        <ProgramServicesAmt>11398</ProgramServicesAmt>
        <ManagementAndGeneralAmt>235156</ManagementAndGeneralAmt>
        <FundraisingAmt>1</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>77303</TotalAmt>
        <ProgramServicesAmt>16693</ProgramServicesAmt>
        <ManagementAndGeneralAmt>60610</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>19164</TotalAmt>
        <ProgramServicesAmt>2560</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16604</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2720828</TotalAmt>
        <ProgramServicesAmt>1990871</ProgramServicesAmt>
        <ManagementAndGeneralAmt>699014</ManagementAndGeneralAmt>
        <FundraisingAmt>30943</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>0</TotalAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>6350432</TotalAmt>
        <ProgramServicesAmt>4406071</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1908862</ManagementAndGeneralAmt>
        <FundraisingAmt>35499</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>3151430</TotalAmt>
        <ProgramServicesAmt>1899486</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1250211</ManagementAndGeneralAmt>
        <FundraisingAmt>1733</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>210383</TotalAmt>
        <ProgramServicesAmt>177586</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32271</ManagementAndGeneralAmt>
        <FundraisingAmt>526</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>112809</TotalAmt>
        <ProgramServicesAmt>21932</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31529</ManagementAndGeneralAmt>
        <FundraisingAmt>59348</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>410237</TotalAmt>
        <ProgramServicesAmt>237301</ProgramServicesAmt>
        <ManagementAndGeneralAmt>172493</ManagementAndGeneralAmt>
        <FundraisingAmt>443</FundraisingAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>2493816</TotalAmt>
        <ProgramServicesAmt>1671460</ProgramServicesAmt>
        <ManagementAndGeneralAmt>821320</ManagementAndGeneralAmt>
        <FundraisingAmt>1036</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>341715</TotalAmt>
        <ManagementAndGeneralAmt>341715</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>RECLASS TO FUNDRAISING</Desc>
        <TotalAmt>-144867</TotalAmt>
        <FundraisingAmt>-144867</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACEUTICALS</Desc>
        <TotalAmt>4674709</TotalAmt>
        <ProgramServicesAmt>4666497</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8183</ManagementAndGeneralAmt>
        <FundraisingAmt>29</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MAINTENANCE &amp; REPAIRS</Desc>
        <TotalAmt>1030543</TotalAmt>
        <ProgramServicesAmt>579378</ProgramServicesAmt>
        <ManagementAndGeneralAmt>447757</ManagementAndGeneralAmt>
        <FundraisingAmt>3408</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CONTRIBUTED SUPPLIES</Desc>
        <TotalAmt>3858744</TotalAmt>
        <ProgramServicesAmt>3822303</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2871</ManagementAndGeneralAmt>
        <FundraisingAmt>33570</FundraisingAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>97575746</TotalAmt>
        <ProgramServicesAmt>81571229</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15460269</ManagementAndGeneralAmt>
        <FundraisingAmt>544248</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>14620</BOYAmt>
        <EOYAmt>15920</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>29954043</BOYAmt>
        <EOYAmt>22528557</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>994250</BOYAmt>
        <EOYAmt>863621</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>5859928</BOYAmt>
        <EOYAmt>6942914</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>704089</BOYAmt>
        <EOYAmt>845651</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>801702</BOYAmt>
        <EOYAmt>1796721</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>67268321</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>20068345</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>41434940</BOYAmt>
        <EOYAmt>47199976</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1659627</BOYAmt>
        <EOYAmt>1905372</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>81423199</BOYAmt>
        <EOYAmt>82098732</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>6692613</BOYAmt>
        <EOYAmt>7078036</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>13606322</BOYAmt>
        <EOYAmt>12841145</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>157906</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>20456841</BOYAmt>
        <EOYAmt>19919181</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>58269161</BOYAmt>
        <EOYAmt>59594798</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>2697197</BOYAmt>
        <EOYAmt>2584753</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>60966358</BOYAmt>
        <EOYAmt>62179551</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>81423199</BOYAmt>
        <EOYAmt>82098732</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>944729</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>268464</NetUnrlzdGainsLossesInvstAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbyingGrp />
      <TotalDirectLobbyingGrp>
        <FilingOrganizationsTotalAmt>19165</FilingOrganizationsTotalAmt>
      </TotalDirectLobbyingGrp>
      <TotalLobbyingExpendGrp>
        <FilingOrganizationsTotalAmt>19165</FilingOrganizationsTotalAmt>
      </TotalLobbyingExpendGrp>
      <OtherExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>81552064</FilingOrganizationsTotalAmt>
      </OtherExemptPurposeExpendGrp>
      <TotalExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>81571229</FilingOrganizationsTotalAmt>
      </TotalExemptPurposeExpendGrp>
      <LobbyingNontaxableAmountGrp>
        <FilingOrganizationsTotalAmt>1000000</FilingOrganizationsTotalAmt>
      </LobbyingNontaxableAmountGrp>
      <GrassrootsNontaxableGrp>
        <FilingOrganizationsTotalAmt>250000</FilingOrganizationsTotalAmt>
      </GrassrootsNontaxableGrp>
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <AvgLobbyingNontaxableAmountGrp>
        <CurrentYearMinus3Amt>1000000</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>1000000</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>1000000</CurrentYearMinus1Amt>
        <CurrentYearAmt>1000000</CurrentYearAmt>
        <TotalAmt>4000000</TotalAmt>
      </AvgLobbyingNontaxableAmountGrp>
      <LobbyingCeilingAmt>6000000</LobbyingCeilingAmt>
      <AvgTotalLobbyingExpendGrp>
        <CurrentYearMinus3Amt>65477</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>15069</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>6436</CurrentYearMinus1Amt>
        <CurrentYearAmt>19265</CurrentYearAmt>
        <TotalAmt>106247</TotalAmt>
      </AvgTotalLobbyingExpendGrp>
      <AvgGrassrootsNontaxableGrp>
        <CurrentYearMinus3Amt>250000</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>250000</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>250000</CurrentYearMinus1Amt>
        <CurrentYearAmt>250000</CurrentYearAmt>
        <TotalAmt>1000000</TotalAmt>
      </AvgGrassrootsNontaxableGrp>
      <GrassrootsCeilingAmt>1500000</GrassrootsCeilingAmt>
      <AvgGrassrootsLobbyingExpendGrp>
        <CurrentYearMinus3Amt>53045</CurrentYearMinus3Amt>
        <TotalAmt>53045</TotalAmt>
      </AvgGrassrootsLobbyingExpendGrp>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>1276608</BeginningYearBalanceAmt>
        <ContributionsAmt>0</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>268464</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>1545072</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>1314308</BeginningYearBalanceAmt>
        <ContributionsAmt>0</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-37700</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>1276608</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>1209376</BeginningYearBalanceAmt>
        <ContributionsAmt>0</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>104932</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>1314308</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>1168070</BeginningYearBalanceAmt>
        <ContributionsAmt>5195</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>36111</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>1209376</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>1165960</BeginningYearBalanceAmt>
        <ContributionsAmt>4025</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-1915</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>1168070</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.04300</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.72480</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.23220</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>true</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>true</RelatedOrgListSchRInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>3657041</OtherCostOrOtherBasisAmt>
        <BookValueAmt>3657041</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>50602177</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>13483015</DepreciationAmt>
        <BookValueAmt>37119162</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>13009103</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>6585330</DepreciationAmt>
        <BookValueAmt>6423773</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp />
      <TotalBookValueLandBuildingsAmt>47199976</TotalBookValueLandBuildingsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <TotalLiabilityAmt>0</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>99573543</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>268464</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>394043</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>390561</OtherRevenueAmt>
      <RevenueNotReportedAmt>1053068</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>98520475</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>98520475</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>98360350</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>394043</DonatedServicesUseFcltsAmt>
      <OtherExpensesIncludedAmt>390561</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>784604</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>97575746</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>97575746</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Endowment funds are used to support the operations of Peak Vista Community Health Center. SCHEDULE D, PART X, LINE 2 Both Peak Vista and the Foundation are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code and qualify for the charitable contribution deduction. The organization believes that it does not have any uncertain tax positions that are material to the financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XI LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES - INCLUDED IN 990 INCOME: $ 242,710 Reclass contribution expense -24,900 Reclass Loss on asset disposal 27,884 Reclass Fundraising Expenses 144,867 __________ $ 390,561</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, Part XII line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES - INCLUDED IN 990 INCOME: $ 242,710 Reclass contribution expense -24,900 Reclass Loss on asset disposal 27,884 Reclass Fundraising Expenses 144,867 __________ $ 369,096</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="IRS990ScheduleG">
      <FundraisingEventInformationGrp>
        <Event1Nm>Break. of Champ</Event1Nm>
        <GrossReceiptsEvent1Amt>236176</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>12931</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>223245</GrossRevenueEvent1Amt>
        <RentFacilityCostsEvent1Amt>1800</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>40419</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>30000</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>72648</OtherDirectExpensesEvent1Amt>
        <OtherEventsTotalCnt>0</OtherEventsTotalCnt>
        <GrossReceiptsTotalAmt>236176</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>12931</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>223245</GrossRevenueTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>1800</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>40419</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>30000</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>72648</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>144867</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>78378</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>true</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Pamela McManus</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>298576</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1962</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>11200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10413</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>322151</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lisa Ramey</PersonNm>
        <TitleTxt>Chief Medical &amp; Dental Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>256141</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1122</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>10293</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>843</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>268399</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Tracy Narvet</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>200013</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>278</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8015</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8103</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>216409</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Michael Welch Retired 08032019</PersonNm>
        <TitleTxt>Chief Medical &amp; Dental Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>187624</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>3955</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>7680</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>904</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>200163</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Louie Larimer Term 05072019</PersonNm>
        <TitleTxt>Chief Strategy Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>100871</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>79338</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7225</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>5382</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>192816</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Scott Robinson</PersonNm>
        <TitleTxt>VP of Medical</TitleTxt>
        <BaseCompensationFilingOrgAmt>250217</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1122</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>10056</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>261395</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Darvi C Rahaman</PersonNm>
        <TitleTxt>VP of Medical</TitleTxt>
        <BaseCompensationFilingOrgAmt>242333</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>2162</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>9783</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16338</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>270616</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Karen C Campbell Munch</PersonNm>
        <TitleTxt>VP of Medical</TitleTxt>
        <BaseCompensationFilingOrgAmt>219891</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>2162</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8885</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10197</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>241135</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Richard Leensvaart</PersonNm>
        <TitleTxt>VP of Dental</TitleTxt>
        <BaseCompensationFilingOrgAmt>191790</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>278</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>7684</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10406</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>210158</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Peter A Liehr</PersonNm>
        <TitleTxt>OB GYN Provider</TitleTxt>
        <BaseCompensationFilingOrgAmt>426688</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>282</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>11200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16338</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>454508</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jeffrey D McCutcheon</PersonNm>
        <TitleTxt>Director Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>395985</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>8382</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>11200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16338</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>431905</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Catharine Roos</PersonNm>
        <TitleTxt>OB GYN Provider</TitleTxt>
        <BaseCompensationFilingOrgAmt>334457</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>3082</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>11200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9815</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>358554</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Amy Clauss</PersonNm>
        <TitleTxt>OB GYN Provider</TitleTxt>
        <BaseCompensationFilingOrgAmt>298674</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>5722</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>11200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>843</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>316439</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Timothy Brininger Term 1026201</PersonNm>
        <TitleTxt>OB GYN Provider</TitleTxt>
        <BaseCompensationFilingOrgAmt>238004</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7510</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>738</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>246252</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Determination of the CEO's salary at Peak Vista Community Health Centers is determined by making salary comparisons of similar positions at community health centers and other similar agencies in the state, Federal Region VIII, nation, and a survey of Mountain States salaries. From this analysis, a proposal is made to the Board of Directors and the proposal is accepted by them or adjustments are made as appropriate based on merit and budget constraints.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4a</FormAndLineReferenceDesc>
        <ExplanationTxt>LOUIE LARIMER RECEIVED $79,338 OF SEVERANCE PAY</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COLORADO HEALTH FACILITIES AUTHORITY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>840752932</BondIssuerEIN>
        <BondIssuedDt>2012-11-20</BondIssuedDt>
        <IssuePriceAmt>9100000</IssuePriceAmt>
        <PurposeDesc>See Part VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COLORADO HEALTH FACILITIES AUTHORITY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>840752932</BondIssuerEIN>
        <BondIssuedDt>2013-12-12</BondIssuedDt>
        <IssuePriceAmt>8300000</IssuePriceAmt>
        <PurposeDesc>See Part VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>2691811</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>8379000</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>1419</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>127705</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>4747565</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>3926571</OtherSpentProceedsAmt>
        <UnspentAmt>425864</UnspentAmt>
        <SubstantialCompletionYr>2013</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>1770105</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>8150304</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>226502</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>149696</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>7652061</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>498243</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2014</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>false</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </HedgeProviderName>
        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </HedgeProviderName>
        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I line A column F</FormAndLineReferenceDesc>
        <ExplanationTxt>Description of purpose: The bonds were used to construct new facilities, buy medical and office equipment, and remodel buildings. The new facility was constructed on vacant land at 350 Lyckman Dr. in Fountain, Colorado. The medical equipment purchased from these bonds was used for patient care. The remodeling was done at a building at 3205 North Academy Blvd for administrative and supporting services and related office equipment.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I line B column F</FormAndLineReferenceDesc>
        <ExplanationTxt>The bonds were used to construct new facilities, buy medical and office equipment, and remodel buildings. The new facility was constructed on vacant land at 350 Lyckman Dr. in Fountain, Colorado. The medical equipment purchased from these bonds was used for patient care. The remodeling was done at a building at 3205 North Academy Blvd for administrative and supporting services and related office equipment.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="IRS990ScheduleM">
      <WorksOfArtGrp />
      <ArtHistoricalTreasuresGrp />
      <ArtFractionalInterestGrp />
      <BooksAndPublicationsGrp />
      <ClothingAndHouseholdGoodsGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <NoncashContributionsRptF990Amt>35921</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>COST</MethodOfDeterminingRevenuesTxt>
      </ClothingAndHouseholdGoodsGrp>
      <CarsAndOtherVehiclesGrp />
      <BoatsAndPlanesGrp />
      <IntellectualPropertyGrp />
      <SecuritiesPubliclyTradedGrp />
      <SecuritiesCloselyHeldStockGrp />
      <SecurPrtnrshpTrustIntrstsGrp />
      <SecuritiesMiscellaneousGrp />
      <QualifiedContribHistStructGrp />
      <QualifiedContribOtherGrp />
      <RealEstateResidentialGrp />
      <RealEstateCommercialGrp />
      <RealEstateOtherGrp />
      <CollectiblesGrp />
      <FoodInventoryGrp />
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>3</ContributionCnt>
        <NoncashContributionsRptF990Amt>3746356</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>SEE PART II</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <TaxidermyGrp />
      <HistoricalArtifactsGrp />
      <ScientificSpecimensGrp />
      <ArchaeologicalArtifactsGrp />
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>other</Desc>
        <ContributionCnt>5</ContributionCnt>
        <NoncashContributionsRptF990Amt>36441</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE M, PART I, LINE 20</FormAndLineReferenceDesc>
        <ExplanationTxt>DISCOUNT REPLACEMENT COST</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE M, PART I, COLUMN B</FormAndLineReferenceDesc>
        <ExplanationTxt>THESE AMOUNTS REPRESENT NUMBER OF CONTRIBUTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Peak Vista Community Health Centers' mission is to provide exceptional healthcare to people facing access barriers through clinical programs and education. Peak Vista served over 93,000 people living in the Pikes Peak and East Central regions of Colorado in 2019. Peak Vista's niche in the these regions' health care marketplace is as a non-profit multi-specialty outpatient provider of quality integrated medical, dental and behavioral health primary care services, mostly for working families. In this role, Peak Vista has endeavored to serve populations that are under or uninsured as well as those on public programs. Partnerships are a significant component of Peak Vista's ability to successfully meet its mission. Peak Vista frequently collaborates with organizations of similar mission to better serve our mutual populations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>To provide exceptional healthcare to people facing access barriers through clinical programs and education, serving over 93,000 people living in the Pikes Peak and East Central Regions of Colorado through 27 health centers spread across 20 service locations. Peak Vista offers numerous ancillary services and programs to benefit our patients to include: First Visitor which provides information to parents and caregivers before and after their baby is born with trained volunteers making home visits designed to connect parents with community resources and early childhood materials. Health education supports patients with management of chronic diseases such as diabetes, high blood pressure, obesity and asthma. The three pharmacy locations provide easy access to counseling and medications. Well Child Waiting Areas welcome healthy children into a secure and child-friendly environment so that patients can attend clinical appointments without the worry of finding outside childcare</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>2019 Peak Vista Community Health Centers' Accomplishments include: Patient Growth - Peak Vista continues to serve a significant portion of the population, serving over 93,000 patients in 2019 or an average of 1,394 patient visits per day (in 2006 the average was 600). Peak Vista's Mobile Health Services Van hours increase steadily to expand care to Colorado Springs. The van now offers exceptional health care 40 hours per week, spending time at various partner agencies in an effort to eliminate access barriers daily. Peak Vista received grant dollars from the Pikes Peak Area Council of Governments Area Agency on Aging. This grant enables Peak Vista to offer Audiology services to low-income seniors. Community of Caring donated an audiology booth to the Health Center at Divide and will now offer an Audiology program. UCHealth Memorial Hospital North expanded its labor and delivery department. The Peak Vista Women's Health Center is now delivering all babies at UCHealth Memorial Hospital North. The Family Medicine Residency (FMR) program received Continuing Accreditation from the Accreditation Council for Graduate Medical Education (ACGME). This means the FMR program is fully accredited for 10 years. Peak Vista also will maintain AOA accreditation through June 30th, 2020. Peak Vista opened a new access point for care in February as the result of the increased demand and need for integrated health services in Southeast Colorado Springs. The new Health Center at Jet Wing opened at full capacity in October. In partnership with Colorado Springs School District 11, Peak Vista opened a new primary health care facility on the Mitchell High School campus. This health center provides comprehensive primary medical and dental care with integrated behavioral health services to community members of all ages. Peak Vista's Education Health Initiative (EHI) encompasses Peak Vista's Advanced Practice Registered Nurse (APRN) fellowship, the Family Medicine Residency (FMR) program and medical student coordination with a focus on developing and training new health care professionals. EHI is an effort to build a local solution to the national health care workforce shortage, with the ultimate goal of improving access to quality care in our community. Advanced Practice Registered Nurse Fellowship (APRN) - In the fall of 2019, Peak Vista saw the commencement of our fourth class of Advanced Practice Registered Nurse (APRN) Primary Care fellowship, a program designed to seamlessly transition recent nurse practitioner graduates from the academic sphere to a clinical setting. The one-year fellowship combines didactic and clinical learning in a team-oriented, patient-centered clinical environment. Of the previous three graduating classes, 80% continued their career at Peak Vista throughout the various health centers. Family Medicine Residency Program (FMR)- Peak Vista's Family Medicine Residency (FMR) is dually accredited with the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA). It is the only primary care residency of its kind in Peak Vista's service area. The three-year program beginning in July of 2016 welcomed eight osteopathic physicians. The curriculum, program offerings and emphasis of partnership with community agencies and leaders evoked an overwhelmingly positive response. It was also met with strong community support from local hospitals, health care providers and specialty physicians. Residents learn through patient interaction, bedside teaching and structured educational sessions. Peak Vista received over 230 applications and interviewed 54 candidates for the inaugural class. With the support of numerous community partners, Peak Vista's Family Medicine Residency (FMR) program welcomed its fourth class of eight Residents in June 2019. Peak Vista graduated our inaugural class of Residents in June 2019. With the success of both the FMR and APRN, Peak Vista became a host clinic in 2017 for the National Institute for Medical Assistant Advancement (NIMAA), an important new nonprofit training program that will help shape Peak Vista's health care work force. Together both NIMAA and Peak Vista will focus on a new and innovative approach to medical assistant training, increased productivity and increased quality of care. Peak Vista graduated its second class of NIMAA students in April 2019. We also proudly adapted our own Dental Assistant Career Development Program, an accelerated program that includes a four-week didactic period and up to eight weeks of hands-on training with expert trainers. After completion of the first two phases, the trainee will be an entry level dental assistant.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTINUED: A full line of ancillary services, all of which patients access in high volumes, compliment Peak Vista's primary care offerings. Health Education and care coordination support patients with management of chronic diseases. Patients have access to pharmacy services on-site providing easy access to counseling and medications. Well Child Waiting Areas (3 locations) welcome healthy children into a secure and child friendly environment so that parents and other siblings can attend appointments without concern or distraction. First Visitor provides information to parents and caregivers before and after a baby is born with trained volunteers making home visits designed to connect parents with community resources and early childhood materials.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>Peak Vista Community Health Centers' other services include: The Reach Out and Read Program (ROAR); a nationally acclaimed program that encourages reading by providing every Peak Vista patient from the age of six months to five years with a new, age-appropriate book to take home and keep when they visit our Pediatric Health Centers or any Family Health Center for well-child check-ups.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>Peak Vista Community Health Centers' compliance plan and bylaws contain policies on conflict of interest. In order to ensure that conflicts of interest are disclosed, board members and leadership sign a disclosure statement when first appointed or employed and annually thereafter. Human Resources distribute the disclosure statements to leadership and the CEO's staff ensures that the statement is given to the board of directors. Any new board member or leadership staff is given education on the conflict of interest policy. If at any time during the year a potential conflict of interest arises, board members are required to inform those charged with approving the transaction of the conflict, disclose any material facts and excuse themselves from discussion and voting as appropriate. FORM 990, PART VI, SECTION B, LINE 15 Determination of salaries of highly compensated employees at Peak Vista Community Health Centers are determined by making salary comparisons of similar positions at community health centers and other similar agencies in the state, Federal Region VIII, national and a survey of Mountain States salaries. From this analysis, a proposal is made to the CEO, Executive Vice President, Chief Financial Officer, Chief Medical and Dental Officer, and the Vice President of Human Resources, and the proposal is accepted or adjustments are made as appropriate based on budget constraints. The CEO's salary comparison is completed by external independent experts and reviewed and approved by the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>As a private nonprofit, the documents are not open to the public. Peak Vista Community Health Centers does however produce an annual report for the public highlighting key events which also includes a financial summary.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS PROCESS DID NOT CHANGE IN the current year.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PEAK VISTA COMMUNTIY HEALTH CENTERS FDN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3205 N ACADEMY BLVD STE 130</AddressLine1Txt>
          <CityNm>COLORADO SPRINGS</CityNm>
          <StateAbbreviationCd>CO</StateAbbreviationCd>
          <ZIPCd>80917</ZIPCd>
        </USAddress>
        <EIN>203640104</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CO</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11C</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>See PartVIII</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Clinical Partners of Colorado Springs</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <EIN>462879718</EIN>
      </IdRelatedOrgTxblPartnershipGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PEAK VISTA COMMUNITY HEALTH CENTERS FDN</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>b,S</TransactionTypeTxt>
        <InvolvedAmt>24900</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>cash transfer</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II line 1 column F</FormAndLineReferenceDesc>
        <ExplanationTxt>Direct controlling entity of Peak Vista Community Health Centers Foundation is the reporting entity, Peak Vista Community Health Center.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>