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      <ReconcilationRevenueExpnssAmt>-52972</ReconcilationRevenueExpnssAmt>
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          <BusinessNameLine1Txt>CHARLES COUNTY NURSING AND REHABILITATION CENTER INC</BusinessNameLine1Txt>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>FORM 990, SCHEDULE A, PART IV, SECTION C, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>WHILE THE FILING ENTITY'S BOARD ROSTER IS NOT A MAJORITY OF ITS SUPPORTED ORGANIZATION'S BOARD, TWO OF THE FIVE MEMBERS OF THE FILING ORGANIZATION'S BOARD ARE ALSO MEMBERS OF THE SUPPORTED ORGANIZATION'S BOARD AND THERE IS COMMON MANAGEMENT OF BOTH ENTITIES AS THE PRESIDENT IS THE SAME FOR BOTH ORGANIZATIONS. ADDITIONALLY, FAMILY OF CARE ALLIANCE , INC (ANOTHER SUPPORTING ORGANIZATION OF CHARLES COUNTY NURSING AND REHABILITATION CENTER, INC) HAS THE SOLE POWER TO ELECT THE BOARD MEMBERS OF BOTH THE FILING AND SUPPORTED ORGANIZATIONS AND AS OF JUNE 30, 2023 ALL FIVE BOARD MEMBERS OF THE FILING ORGANIZATION REPRESENTED 5 OF THE 8 BOARD MEMBERS OF FAMILY OF CARE ALLIANCE, INC.</ExplanationTxt>
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      <LeaseholdImprovementsGrp />
      <EquipmentGrp />
      <OtherLandBuildingsGrp />
      <TotalBookValueLandBuildingsAmt>17291744</TotalBookValueLandBuildingsAmt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATES</Desc>
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      <TotalLiabilityAmt>1671509</TotalLiabilityAmt>
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      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Andrea Dwyer</PersonNm>
        <TitleTxt>President/CEO (through 4/23)</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>172013</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>51604</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>223617</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>MD HEALTH &amp; HIGHER EDUCATION FACILITY AUTHO</BusinessNameLine1Txt>
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        <BondIssuedDt>2012-06-09</BondIssuedDt>
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        <PurposeDesc>RF-FI 2007 BOND ISSUE &amp; CONVENTIO</PurposeDesc>
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        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
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        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>2614559</RetiredAmt>
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        <TotalProceedsAmt>8000000</TotalProceedsAmt>
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        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>0</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>97179</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>2497995</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>5404826</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2015</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
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      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.33000</PrivateBusUseByOthersPct>
        <TotalPrivateBusinessUsePct>0.33000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
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        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
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        <BondReferenceCd>A</BondReferenceCd>
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        <VariableRateIssueInd>false</VariableRateIssueInd>
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        <GICProviderName>
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        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K, PART I, BOND ISSUES:</FormAndLineReferenceDesc>
        <ExplanationTxt>(A) ISSUER NAME: MD HEALTH &amp; HIGHER EDUCATION FACILITY AUTHORIZATION (F) DESCRIPTION OF PURPOSE: RF-FI 2007 BOND ISSUE &amp; CONVENTION SCHEDULE-K, SUPPLEMENTAL INFORMATION: PART III - PRIVATE BUSINESS USE: THE ORGANIZATION ALLOWS A BEAUTICIAN TO SERVICE RESIDENTS WHICH THE ORGANIZATION CONSIDERS TO BE PRIVATE BUSINESS USE. HOWEVER, THE ORGANIZATION DOES NOT HAVE ANY LEASE ARRANGEMENTS OR SERVICE CONTRACTS WITH THE BEAUTICIAN OR ANY OTHER INDIVIDUAL OR ORGANIZATION. AS SUCH, IT DOES NOT ROUTINELY ENGAGE BOND COUNSEL. SHOULD THE ORGANIZATION ENGAGE IN A LEASE OR MANAGEMENT CONTRACT THAT MAY HAVE SAFE HARBOR REQUIREMENTS IT WILL ENGAGE BOND COUNSEL AS DEEMED NECESSARY. PART IV, LINE 7: BOND ISSUE FUNDS WERE INITIALLY RELEASED TO REFUND A PRIOR ISSUE AND TO MEET COST OF ISSUANCE EXPENSES. FUNDS RELEASED TO PROVIDE FOR CAPITAL IMPROVEMENTS ARE ONLY UPON RECEIPT OF DOCUMENTED PROOF THAT EXPENSES HAVE BEEN INCURRED. THE ORGANIZATION DOES NOT HOLD ANY FUNDS IN ESCROW OR OTHER ACCOUNTS AND THEREBY HAS NO EXPOSURE TO ARBITRAGE. AS SUCH, THE ORGANIZATION DOES NOT HAVE A WRITTEN POLICY FOR MONITORING. SHOULD THE TERMS OF ANY BOND ISSUE CHANGE, THE ORGANIZATION WOULD PROVIDE FOR ANY POLICIES NECESSARY TO MEET ALL BOND COMPLIANCE REGULATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTROL OVER MANAGEMENT DUTIES IS DELAGATED TO FAMILY OF CARE ALLIANCE, INC. (90-0860390), A RELATED ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>FAMILY OF CARE ALLIANCE (90-0860390), A MARYLAND NONSTOCK CORPORATION, IS THE SOLE MEMBER OF FAMILY OF CARE REAL ESTATE HOLDING COMPANY, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER, FAMILY OF CARE ALLIANCE, ELECTS ALL BOARD MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER HAS RESERVED THE FOLLOWING POWERS AND SHALL REQUIRE THE AFFIRMATIVE VOTE OR WRITTEN CONSENT OF THE SOLE MEMBER: 1. THE SALE, LEASE, PLEDGE, OR OTHER DISPOSITION OF REAL PROPERTY OWNED BY THE CORPORATION. 2. THE IMPOSITION OF A MORTGAGE ON ANY REAL PROPERTY OWNED BY THE CORPORATION UNLESS SUCH MORTGAGE IS REQUIRED TO SECURE A DEBT WHICH IS NECESSARY TO FINANCE THE COST OF COMPLIANCE WITH OPERATIONAL OR PHYSICAL PLAN STANDARDS REQUIRED BY LAW. 3. ADOPTION, AMENDMENT, OR REPEAL OF ANY PLAN OF DISSOLUTION, MERGER OR CONSOLIDATION OF THE CORPORATION. 4. ADOPTION, AMENDMENT, OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE CORPORATION AND 5. ADOPTION, AMENDMENT, OR REPEAL OF THE BY-LAWS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CFO WILL COMPARE THE DRAFT FORM 990 TO THE PREVIOUS YEAR'S RETURN IN DETAIL, LOOKING FOR ANY SIGNIFICANT DIFFERENCES OR OMISSIONS. THE CFO ALSO TRACES AMOUNTS TO THE FINANCIAL STATEMENTS AND TRIAL BALANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C:</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT THAT AFFIRMS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE BOARD AS A WHOLE MONITORS THE POLICY. ANY BOARD MEMBER, OFFICER, OR KEY EMPLOYEE WHO IS INVOLVED IN A CONFLICT SITUATION WILL REMOVE HIMSELF OR HERSELF FROM ANY DECISION-MAKING REGARDING THE CONFLICT. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE CONFLICT OF INTEREST POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON WRITTEN REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization is currently working with its independent accountant's regarding obtaining an audit for the fiscal year ended June 30, 2023. THE 990 WAS PREPARED BASED ON THE BEST INFORMATION AVAILABLE AT THE TIME OF FILING. AN AMENDED INFORMATION RETURN WILL BE FILED, IF NECESSARY, UPON COMPLETION OF THE FINANCIAL STATEMENT AUDIT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION HAS A COMMITEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT ACCOUNANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR FISCAL YEAR END.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, Section A, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>During the FYE 2023, the Organization's By-Laws were amended to allow for the appointment of a board member as interim President with limited volunteer duties.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Charles Co Nursing &amp; Rehab Center INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>9375 Chesapeake Street Suite 211</AddressLine1Txt>
          <CityNm>La Plata</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20646</ZIPCd>
        </USAddress>
        <EIN>521071433</EIN>
        <PrimaryActivitiesTxt>SEE PART VII</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SEE PART VII</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Family of Care Alliance Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>9375 Chesapeake Street Suite 211</AddressLine1Txt>
          <CityNm>La plata</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20626</ZIPCd>
        </USAddress>
        <EIN>900860390</EIN>
        <PrimaryActivitiesTxt>SEE PART VII</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B,II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SEE PART VII</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Charles Co Nursing &amp; Rehab Center Found</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>9375 Chesapeake Street Suite 211</AddressLine1Txt>
          <CityNm>la Plata</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20626</ZIPCd>
        </USAddress>
        <EIN>201666771</EIN>
        <PrimaryActivitiesTxt>SEE PART VII</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SEE PART VII</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>true</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Column B, &amp; F Primary activity &amp; Direct controlling entity</FormAndLineReferenceDesc>
        <ExplanationTxt>NAME OF RELATED ORGANIZATION : CHARLES CO. NURSING &amp; REHAB CENTER, INC. PRIMARY ACTIVITY : REHAB AND AGING SERVICES DIRECT CONTROLLING ENTITY : FAMILY OF CARE ALLIANCE, INC. NAME OF RELATED ORGANIZATION : FAMILY OF CARE ALLIANCE, INC. PRIMARY ACTIVITY : FUNDRAISING AND SUPPORT FOR AFFILIATED ORGANIZATIONS DIRECT CONTROLLING ENTITY : N/A NAME OF RELATED ORGANIZATION : CHARLES CO. NURSING &amp; REHAB CENTER, INC. PRIMARY ACTIVITY : FUNDRAISING FOR RELATED ENTITY DIRECT CONTROLLING ENTITY : FAMILY OF CARE ALLIANCE, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
