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      <TotalReportableCompFromOrgAmt>3496074</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>69591</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>66</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>COMFORT ANESTHESIA ASSOCIATES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>11704 NANTWICK CT</AddressLine1Txt>
            <CityNm>BAKERSFIELD</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93311</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES ANESTHESIA</ServicesDesc>
        <CompensationAmt>1246521</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DELANO HEALTH ASSOCIATES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1401 GARCES HWY</AddressLine1Txt>
            <CityNm>DELANO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93215</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES REGISTRY</ServicesDesc>
        <CompensationAmt>654708</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CENTRAL CALIFORNIA HOSPITALISTS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6001 TRUXTUN AVE BLDG A STE 180</AddressLine1Txt>
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            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93309</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES HOSPITALISTS</ServicesDesc>
        <CompensationAmt>375000</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TEAM PHYSICIANS OF CALIFORNIA MEDICAL GR</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 634850</AddressLine1Txt>
            <CityNm>CINCINNATI</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>452634850</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES ER PHYSICIANS</ServicesDesc>
        <CompensationAmt>276382</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>STANLEY CALDERWOOD MD</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>600 HOSKING AVE APT 46D</AddressLine1Txt>
            <CityNm>BAKERSFIELD</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93307</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES PEDIATRIC HOSPITAL</ServicesDesc>
        <CompensationAmt>245050</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>9</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>1185</AllOtherContributionsAmt>
      <TotalContributionsAmt>1185</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICES</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>81846957</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>81846957</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>81846957</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1332692</TotalRevenueColumnAmt>
        <ExclusionAmt>1332692</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>317758</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>101290</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>216468</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>216468</TotalRevenueColumnAmt>
        <ExclusionAmt>216468</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>5030800</SecuritiesAmt>
        <OtherAmt>12000</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>5036850</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-6050</SecuritiesAmt>
        <OtherAmt>12000</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>5950</TotalRevenueColumnAmt>
        <ExclusionAmt>5950</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <GrossSalesOfInventoryAmt>52356</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>190098</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-137742</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>-137742</UnrelatedBusinessRevenueAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAFETERIA SALES</Desc>
        <BusinessCd>722100</BusinessCd>
        <TotalRevenueColumnAmt>291077</TotalRevenueColumnAmt>
        <ExclusionAmt>291077</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MANAGEMENT FEES - DHA</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>106140</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>106140</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>140318</TotalRevenueColumnAmt>
        <ExclusionAmt>140318</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>537535</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>83803045</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>81846957</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>-31602</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1986505</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2047545</TotalAmt>
        <ProgramServicesAmt>291148</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1756397</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>28524127</TotalAmt>
        <ProgramServicesAmt>21818966</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6705161</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>4771966</TotalAmt>
        <ProgramServicesAmt>3292142</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1479824</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>5711307</TotalAmt>
        <ProgramServicesAmt>3962649</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1748658</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>491543</TotalAmt>
        <ManagementAndGeneralAmt>491543</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>72363</TotalAmt>
        <ManagementAndGeneralAmt>72363</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>5546322</TotalAmt>
        <ProgramServicesAmt>5295727</ProgramServicesAmt>
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        <TotalAmt>71325</TotalAmt>
        <ManagementAndGeneralAmt>71325</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
        <TotalAmt>588931</TotalAmt>
        <ProgramServicesAmt>172673</ProgramServicesAmt>
        <ManagementAndGeneralAmt>416258</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>1927775</TotalAmt>
        <ProgramServicesAmt>1156665</ProgramServicesAmt>
        <ManagementAndGeneralAmt>771110</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>1276138</TotalAmt>
        <ProgramServicesAmt>470181</ProgramServicesAmt>
        <ManagementAndGeneralAmt>805957</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>63259</TotalAmt>
        <ProgramServicesAmt>51655</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11604</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>56564</TotalAmt>
        <ProgramServicesAmt>33760</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22804</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>760090</TotalAmt>
        <ProgramServicesAmt>760090</ProgramServicesAmt>
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      <DepreciationDepletionGrp>
        <TotalAmt>5936906</TotalAmt>
        <ProgramServicesAmt>4678942</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1257964</ManagementAndGeneralAmt>
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      <InsuranceGrp>
        <TotalAmt>450423</TotalAmt>
        <ManagementAndGeneralAmt>450423</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>4962299</TotalAmt>
        <ProgramServicesAmt>4902043</ProgramServicesAmt>
        <ManagementAndGeneralAmt>60256</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PROVISION FOR BAD DEBT</Desc>
        <TotalAmt>3661900</TotalAmt>
        <ManagementAndGeneralAmt>3661900</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>QUALITY ASSURANCE FEES</Desc>
        <TotalAmt>3603234</TotalAmt>
        <ProgramServicesAmt>3603234</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>NON-MEDICAL SUPPLIES</Desc>
        <TotalAmt>2360917</TotalAmt>
        <ProgramServicesAmt>1417431</ProgramServicesAmt>
        <ManagementAndGeneralAmt>943486</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>5742517</TotalAmt>
        <ProgramServicesAmt>2223955</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
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        <ManagementAndGeneralAmt>24496190</ManagementAndGeneralAmt>
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      <OtherLiabilitiesGrp>
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        <EOYAmt>512450</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>51339800</EOYAmt>
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      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
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        <BOYAmt>106055399</BOYAmt>
        <EOYAmt>110993785</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>106055399</BOYAmt>
        <EOYAmt>110993785</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>162333585</EOYAmt>
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      <ReconcilationRevenueExpnssAmt>5175594</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-237208</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
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    <IRS990ScheduleD documentId="RetDoc1040000001">
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        <BookValueAmt>4314177</BookValueAmt>
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        <Desc>DEPOSITS</Desc>
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      <OtherAssetsOrgGrp>
        <Desc>OTHER RECEIVABLES</Desc>
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      <OtherAssetsOrgGrp>
        <Desc>INTEREST RECEIVABLE</Desc>
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      <OtherAssetsOrgGrp>
        <Desc>MEDI-CAL QAF FUND</Desc>
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      <OtherLiabilitiesOrgGrp>
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      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>512450</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOUNDATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE FOUNDATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OTHER DIRECT EXPENSES.</ExplanationTxt>
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      <Percent400Ind>X</Percent400Ind>
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      <FinancialAssistanceBudgetInd>1</FinancialAssistanceBudgetInd>
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      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
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        <DirectOffsettingRevenueAmt>45155982</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>62336</NetCommunityBenefitExpnsAmt>
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      <TotalFinancialAssistanceTyp>
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        <DirectOffsettingRevenueAmt>45155982</DirectOffsettingRevenueAmt>
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        <TotalExpensePct>0.00880</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
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        <NetCommunityBenefitExpnsAmt>1561694</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02080</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
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      </CashAndInKindContributionsGrp>
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      <TotalCommunityBenefitsGrp>
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      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
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      <BadDebtExpenseAttributableAmt>674656</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>9267609</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>10139872</CostOfCareReimbursedByMedcrAmt>
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      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
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        <BusinessName>
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        <USAddress>
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          <CityNm>DELANO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
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        <WebsiteAddressTxt>WWW.DRMC.COM</WebsiteAddressTxt>
        <StateLicenseNum>120000180</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
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      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>DELANO REGIONAL MEDICAL CENTER</BusinessNameLine1Txt>
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        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
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        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>WWW.DRMC.COM/ABOUT-DRMC/COMMUNITY-BENEFITS-REPORTS.PHP</OwnWebsiteURLTxt>
        <OtherWebsiteInd>X</OtherWebsiteInd>
        <OtherWebsiteURLTxt>WWW.HEALTHYKERN.ORG</OtherWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>16</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>HTTP://WWW.DRMC.COM/WP-CONTENT/UPLOADS/2015/09/DRMC-IMPLEMENTATION-STRATEGY</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>400.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>HTTP://WWW.DRMC.COM</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>HTTP://WWW.DRMC.COM</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>HTTP://WWW.DRMC.COM</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <ProspectiveMedicareMedicaidInd>X</ProspectiveMedicareMedicaidInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>DELANO REGIONAL MEDICAL CENTER</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: THE HOSPITAL SURVEYED MEMBERS OF THE COMMUNITY AS WELL AS COMMUNITY ORGANIZATIONS TO GAIN INPUT ON THE HEALTHCARE NEEDS OF THE DELANO AREA. THESE SURVEYS WERE TRANSLATED INTO OUR IMPLEMENTATION PLAN OF OUR CHNA. THE ORGANIZATIONS SURVEYED INCLUDES: THE DELANO UNION SCHOOL DISTRICT, DELANO JOINT UNION HIGH SCHOOL DISTRICT, THE DELANO CHAMBER OF COMMERCE, DELANO PARKS AND RECREATION DEPARTMENT, ROTARY , AND THE KIWANIS CLUB OF DELANO.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>DELANO REGIONAL MEDICAL CENTER</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6A: DIGNITY HOSPITALS IN BAKERSFIELD</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>DELANO REGIONAL MEDICAL CENTER</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: 1. ACCESS TO HEALTHCAREPROVIDE FINANCIAL ASSISTANCE THROUGH BOTH FREE AND DISCOUNTED CARE FOR HEALTHCARE SERVICES CONSISTENT WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.CONNECT THE MEDICALLY INDIGENT TO RESOURCES TO ACCESS MEDICAL HOME. PROVIDE TRANSPORTATION SUPPORT.INVESTIGATE LAUNCHING A MOBILE UNIT TO INCREASED ACCESS TO HEALTH SERVICES IN AREA FARMING COMMUNITIES.PROVIDE FREE PREVENTIVE HEALTH SCREENINGS AT COMMUNITY EVENTS.2. CARDIOVASCULAR DISEASEPROVIDE CHRONIC DISEASE EDUCATION FOCUSED ON PREVENTION AND DISEASE SELF-MANAGEMENT, HEALTHY EATING AND PHYSICAL ACTIVITY.PROVIDE SCREENING FOR CHOLESTEROL, BLOOD PRESSURE AND BMI.OFFER CPR TRAINING TO COMMUNITY RESIDENTS.3. DIABETESPROVIDE DIABETES EDUCATION FOCUSED ON PREVENTION AND DISEASE SELF MANAGEMENT, HEALTHY LIFESTYLES, NUTRITION AND PHYSICAL ACTIVITY.PROVIDE SCREENING FOR CHOLESTEROL, BLOOD PRESSURE, BLOOD GLUCOSE AND BMI.DISTRIBUTE GLUCOMETERS AND GLUCOSE STRIPS TO INDIVIDUALS WITH DIABETES WHO CANNOT AFFORD OR ACCESS THESE DIABETES MONITORING RESOURCES.4. SEXUALLY TRANSMITTED INFECTIONSTHROUGH DRMC WOMEN'S MEDICAL CLINIC AND URGENT CARE CLINIC PROVIDE EDUCATION FOCUSED ON STI PREVENTION AND FAMILY PLANNING SERVICES.DISTRIBUTE CONDOMS TO REDUCE SPREAD OF STISPROVIDE FAMILY PLANNING COUNSELING TO TEENS AND YOUNG PARENTS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>5</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - WASCO MEDICAL PLAZA</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2300 7TH STREET</AddressLine1Txt>
            <CityNm>WASCO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93280</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - DELANO WOMEN'S MEDICAL CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1201 JEFFERSON</AddressLine1Txt>
            <CityNm>DELANO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93215</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT WOMEN'S CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - DELANO DIABETIC CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1519 GARCES HWY STE 103</AddressLine1Txt>
            <CityNm>DELANO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93215</ZIPCd>
          </USAddress>
          <FacilityTxt>DIABETIC MONITORING &amp; SCREENING</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - DELANO URGENT CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1201 JEFFERSON 12TH AVE ENTRANCE</AddressLine1Txt>
            <CityNm>DELANO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93215</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT URGENT CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>5 - DELANO WOUND CARE CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1519 GARCES HWY STE 103</AddressLine1Txt>
            <CityNm>DELANO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>93215</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT WOUND CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7, COLUMN (F):</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,661,900.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE FOOTNOTE 1 ON AUDITED FINANCIAL STATEMENTS FOR FOOTNOTES DISCUSSING BAD DEBT ("ACCOUNTS RECEIVABLE AND "CHARITY AND INDIGENT CARE" SECTIONS).DUE TO THE AREA WE SERVE MOST OF OUR TRADING AREA CITIZENS ARE LOWER AND LOW MIDDLE INCOME PEOPLE AND THEREFORE MOST OF THE BAD DEBT IS A COMMUNITY BENEFIT AS THEY ARE GETTING MEDICAL CARE AT FREE OR LOWERED AMOUNTS.IF A PATIENT IS IDENTIFIED AT REGISTRATION OR AFTER THE BILLING PROCESS IS INITIATED, THE PATIENT IS, DEPENDING ON INCOME, OFFERED A SLIDING SCALE DISCOUNT BASED ON % OF POVERTY THAT THEY ARE AT, OR FULL WRITEOFF. IF THE PATIENT DOES NOT RESPOND TO BILLING EFFORTS THEN POLICY DICTATES THAT WE SEND THEM, AFTER 4 STATEMENTS, TO COLLECTION. CHARITY CARE CAN STILL BE GIVEN IF THE PATIENT RESPONDS AFTER BEING SENT TO COLLECTION. BECAUSE WE ARE A FARMING COMMUNITY, MOST SELF PAYS ARE TRANSIENT FARM WORKERS AND OFTEN DO NOT STAY AT THE ADDRESS WE HAVE IN THE RECORDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>DEPENDING ON UTILIZATION AND CMI AVERAGE OF THE PATIENTS WE MAY BE EITHER ABOVE OR BELOW COST.COSTING METHODOLOGY: TOTAL COST AS A PERCENTAGE OF TOTAL NET REVENUE AND APPLY TOTAL COST TO THE NET REVENUE FOR MEDICARE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>ONCE A PATIENT IS IDENTIFIED AS A CHARITY CARE PATIENT ALL COLLECTION EFFORTS CEASE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>DELANO REGIONAL MEDICAL CENTER IS PART OF A CORE GROUP OF LOCAL HEALTHCARE AND COMMUNITY AGENCIES, THAT ASSESSES THE COMMUNITY NEEDS WE SERVE. THROUGH THE CREATION OF A WEB BASED INTERACTIVE NEEDS ASSESSMENT (WWW.HEALTHYKERN.ORG) NEEDS ARE ASSESSED THROUGH A CONSTANTLY UPDATED NEEDS ASSESSMENT WITH REPORTING AND TRACKING TOOLS. THIS WEB BASED ASSESSMENT PROVIDES A TOOL FOR COMMUNITY STRATEGIC PLANNING, BRINGS US TOGETHER WITH OTHER STAKEHOLDERS IN OUR COMMUNITY FOR PARTNERSHIP IN DETERMINING THE NEEDS AS WELL AS DEFINING BEST PRACTICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>BY LETTER AND AT ADMISSION, WE INFORM PATIENTS ABOUT THE AVAILABILITY TO HELP APPLY FOR SPECIFIC GOVERNMENTAL PROGRAM ASSISTANCE AND THE PATIENTS' ABILITY TO APPLY FOR CHARITY CONSIDERATION. ALSO, POSTERS IN BOTH ENGLISH AND SPANISH ARE DISPLAYED IN THE ER, WAITING AREA, CLINICS AND HOSPITAL ADMISSION AREAS INFORMING OF THE AVAILABILITY OF THE HOSPITAL'S PROGRAM TO ASSIST THROUGH THE CHARITY OR SLIDING FEE SCALE FOR THEIR BILL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL SERVES A CULTURALLY ABUNDANT AND DIVERSE POPULATION OF APPROXIMATELY 130,000 PEOPLE FROM THREE PRIMARY CULTURAL GROUPS: HISPANIC, FILIPINO AND CAUCASIAN. DRMC IS THE SOLE HOSPITAL PROVIDER WITHIN A 30 MILE RADIUS. OVER THE YEARS, THE HOSPITAL'S SERVICE AREA HAS BEEN FACED WITH MANY CHALLENGES. THESE INCLUDE HIGH RATES OF UNEMPLOYMENT, OBESITY, TEEN PREGNANCY, DIABETES, ASTHMA, POVERTY, SUBSTANCE ABUSE, LOW EDUCATIONAL ATTAINMENT, AND LIMITED ACCESS TO HEALTHCARE SERVICES. ALTHOUGH THESE ISSUES ARE NOT UNIQUE TO OUR SERVICE AREA, DATA SHOW THAT OUR COMMUNITIES ARE MUCH WORSE THAN THE AVERAGE COMMUNITY IN KERN COUNTY OR CALIFORNIA AS A WHOLE.THE FOLLOWING STATISTICS PRESENT A PICTURE OF THE COMMUNITIES WE SERVE.ETHNIC COMPOSITION: HISPANIC 68.47% WHITE 9.2% ASIAN/PACIFIC ISLANDER 15.9% BLACK 5.07% AMERICAN INDIAN 1.4%UNEMPLOYMENT RATE: OUR COMMUNITIES RANK #7 OUT OF THE 101 COMMUNITIES IN THE US FOR THE HIGHEST UNEMPLOYMENT RATE AT 35.2% (SEASONALLY ADJUSTED)ECONOMIC LEVELS: ACCORDING TO 2007 DATA, 28.2% OF OUR POPULATION FALL BELOW THE NATIONAL POVERTY LEVELS. THE CALIFORNIA STATE AVERAGE IS 14.2%EDUCATION: DESPITE GOOD API SCORES, 52% OF FAMILIES CONTINUE TO HAVE AN EDUCATION ATTAINMENT AND READING LEVEL AT THE THIRD GRADE LEVEL OR LOWER.PUBLIC ASSISTANCE: 285 OF FAMILIES RECEIVE AFDC AND 85% OF STUDENTS, DEPENDING ON SEASON, QUALIFY FOR FREE OR REDUCED PRICE LUNCHES AT SCHOOL.CULTURAL: OVER 20% OF FAMILIES ARE MIGRANT FARM WORKERS. 72% OF FAMILY ARE PRIMARILY SPANISH SPEAKING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>DRMC'S COMMITMENT TO THE COMMUNITIES EXTENDS TO THE EMPLOYMENT OF A DIRECTOR OF MARKETING AND COMMUNITY RELATIONS, AS WELL AS A MARKETING &amp; COMMUNITY RELATIONS COORDINATOR BOTH OF WHICH PROVIDE OUTREACH SERVICES WITHIN THE COMMUNITIES DRMC SERVES. THE COMMUNITY RELATIONS COORDINATOR SERVES AS A LIAISON BETWEEN DRMC'S SERVICES AND THE COMMUNITY, IN AN EFFORT TO PROVIDE ASSISTANCE TO THE MEDICALLY UNDERSERVED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>N/A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>CA</ExplanationTxt>
      </SupplementalInformationDetail>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>6039</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>275441</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MEE YOUNG LEE</PersonNm>
        <TitleTxt>PHARMACIST</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>6280</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>224356</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRYANT MENG</PersonNm>
        <TitleTxt>PHARMACIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>199689</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>5289</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>204978</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SAMUEL KHALIL</PersonNm>
        <TitleTxt>PHARMACIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>190303</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7351</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>197654</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>PRESIDENT AND LEADERSHIP PERSONNEL ARE PAID AN ADDITIONAL SUM TO THEIR WAGES IF CERTAIN FINANCIAL GOALS ARE MET IN REGARDS TO NET INCOME, PATIENT SATISFACTION AND DEPARTMENTS MEETING THEIR BUDGETS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
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        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CITY OF DELANO</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>956000702</BondIssuerEIN>
        <CUSIPNum>245584BU0</CUSIPNum>
        <BondIssuedDt>2012-12-20</BondIssuedDt>
        <IssuePriceAmt>30542500</IssuePriceAmt>
        <PurposeDesc>TO REFUND AND RETIRE 1998 BONDS AT A LOWER RATE OF INTEREST</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>6745000</RetiredAmt>
        <TotalProceedsAmt>30607090</TotalProceedsAmt>
        <InReserveFundAmt>3091968</InReserveFundAmt>
        <IssuanceCostsFromProceedsAmt>686695</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>26801555</OtherSpentProceedsAmt>
        <CurrentRefundingInd>1</CurrentRefundingInd>
        <AdvanceRefundingInd>0</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>1</Form8038TFiledInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K SUPPLENTAL INFORMATION</FormAndLineReferenceDesc>
        <ExplanationTxt>PART II, LINE 3 - THE TOTAL INCLUDES CUMULATIVE INVESTMENT EARNINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>RETAIL PHARMACY</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS ONE CLASS OF MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS WERE APPOINTED WHEN THE ORGANIZATION WAS FORMED. UPON DEATH OR RESIGNATION OF ONE OF THE MEMBERS, REMAINING MEMBERS ELECT/APPOINT NEW MEMBER. MEMBERS ARE ELECTED FOR LIFE AND CANNOT BE REMOVED UNLESS THEY CHOOSE TO RESIGN. MEMBERS HAVE THE RIGHT TO NAME NEW MEMBERS OF THE GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGES TO BYLAWS BY THE GOVERNING BODY MUST BE APPROVE BY THE MEMBERS AS WELL AS THE DECISION TO SELL THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>BEFORE FILING, FORM 990 IS REVIEWED BY THE AUDITING FIRM, CEO AND PRESIDENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE THROUGH A COMPLIANCE OFFICER MONITORING SYSTEM. WE STRESS WITH NEW EMPLOYEES AS WELL AS YEARLY AT THE EDUCATION FAIR THAT WE INVITE EMPLOYEES TO REPORT ANY HOSPITAL ACTIVITY THAT THEY THINK MIGHT BE A COMPLIANCE ISSUE EVEN TO A RECORDED PHONE # THAT IS MONITORED BY THE COMPLIANCE COMMITTEE. ALL COMPLIANCE ISSUES ARE INVESTIGATED BY THE COMPLIANCE DIRECTOR AND A COMMITTEE IF NEEDED. IF AN ISSUE EXISTS, A RECOMMENDED COURSE OF ACTION THAT WOULD INCLUDE NOTIFICATION TO THE PROPER AUTHORITY OF THE RESULT OF THE INVESTIGATION IS PRESENTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR THE CEO/CHAIRMAN AND CFO/PRESIDENT ARE BASED ON AN ANNUAL SURVEY OF THE CALIFORNIA HOSPITAL ASSOCIATION, SURVEYING RECRUITMENT AGENCIES, LEGAL COUNSEL CONSULTATION, DISCUSSION WITH BOARD COMMITTEE AND FINAL BOARD APPROVAL. SALARY SURVEYS AS WELL AS THE OTHER SOURCES LISTED ARE CONTINUOUSLY MONITORED. CONTRACTS FOR THE CEO AND CFO WERE REVIEWED, APPROVED AND DOCUMENTED. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED BY THE CEO AND CFO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ADMINISTRATION OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>DELANO HEALTH ASSOCIATES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1401 GARCES HWY</AddressLine1Txt>
          <CityNm>DELANO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93215</ZIPCd>
        </USAddress>
        <EIN>770340007</EIN>
        <PrimaryActivitiesTxt>TO PROVIDE HEALTHCARE REGISTRY SERVICES TO DELANO REGIONAL MEDICAL CENTER.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>654710</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>1219902</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
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      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DELANO HEALTH ASSOCIATES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>656089</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>