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            <AddressLine1Txt>4800 Sanbridge Rd</AddressLine1Txt>
            <CityNm>Raleigh</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27615</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Legal</ServicesDesc>
        <CompensationAmt>180000</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <MembershipDuesAmt>3247396</MembershipDuesAmt>
      <AllOtherContributionsAmt>186417</AllOtherContributionsAmt>
      <TotalContributionsAmt>3433813</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Seminars</Desc>
        <BusinessCd>900001</BusinessCd>
        <TotalRevenueColumnAmt>1045432</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1045432</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>GMCF Contract</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>115680</TotalRevenueColumnAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>1161112</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>165892</TotalRevenueColumnAmt>
      </InvestmentIncomeGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>2572041</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>888339</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>1683702</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1683702</TotalRevenueColumnAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>Miscellaneous income</Desc>
        <BusinessCd>900001</BusinessCd>
        <TotalRevenueColumnAmt>42028</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>42028</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>42028</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>6486547</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1087460</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>60000</TotalAmt>
        <ProgramServicesAmt>60000</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1191956</TotalAmt>
        <ProgramServicesAmt>838639</ProgramServicesAmt>
        <ManagementAndGeneralAmt>357587</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>478594</TotalAmt>
        <ProgramServicesAmt>335016</ProgramServicesAmt>
        <ManagementAndGeneralAmt>143578</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>91224</TotalAmt>
        <ProgramServicesAmt>63857</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27367</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>121368</TotalAmt>
        <ProgramServicesAmt>84957</ProgramServicesAmt>
        <ManagementAndGeneralAmt>36411</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>86530</TotalAmt>
        <ProgramServicesAmt>60571</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25959</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>431930</TotalAmt>
        <ProgramServicesAmt>350270</ProgramServicesAmt>
        <ManagementAndGeneralAmt>81660</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>62508</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>62508</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>262038</TotalAmt>
        <ProgramServicesAmt>183427</ProgramServicesAmt>
        <ManagementAndGeneralAmt>78611</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>39795</TotalAmt>
        <ProgramServicesAmt>19898</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19897</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>77416</TotalAmt>
        <ProgramServicesAmt>75148</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2268</ManagementAndGeneralAmt>
      </TravelGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>13631</TotalAmt>
        <ProgramServicesAmt>13631</ProgramServicesAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>34357</TotalAmt>
        <ProgramServicesAmt>17178</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17179</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <OtherExpensesGrp>
        <Desc>AHCA Dues</Desc>
        <TotalAmt>826982</TotalAmt>
        <ProgramServicesAmt>826982</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Meetings &amp; seminars</Desc>
        <TotalAmt>520248</TotalAmt>
        <ProgramServicesAmt>520248</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>4298577</TotalAmt>
        <ProgramServicesAmt>3449822</ProgramServicesAmt>
        <ManagementAndGeneralAmt>853025</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>678276</BOYAmt>
        <EOYAmt>305258</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>36713</BOYAmt>
        <EOYAmt>2885106</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>3637438</BOYAmt>
        <EOYAmt>264854</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>38732</BOYAmt>
        <EOYAmt>62885</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>325553</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>252017</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>385012</BOYAmt>
        <EOYAmt>73536</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>1410220</BOYAmt>
        <EOYAmt>1551772</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <TotalAssetsGrp>
        <BOYAmt>6186391</BOYAmt>
        <EOYAmt>5143411</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>357400</BOYAmt>
        <EOYAmt>161009</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>3612841</BOYAmt>
        <EOYAmt>471895</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3970241</BOYAmt>
        <EOYAmt>632904</EOYAmt>
      </TotalLiabilitiesGrp>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2216150</BOYAmt>
        <EOYAmt>4405087</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2216150</BOYAmt>
        <EOYAmt>4510507</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>6186391</BOYAmt>
        <EOYAmt>5143411</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>2187970</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>106387</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>false</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleC documentId="000000000000000000000000000002">
      <Form4720FiledSection4955TaxInd>false</Form4720FiledSection4955TaxInd>
      <CorrectionMadeInd>false</CorrectionMadeInd>
      <Form1120POLFiledInd>false</Form1120POLFiledInd>
      <Form4720FiledInd>false</Form4720FiledInd>
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>false</OtherActivitiesInd>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <Form4720Filed4912TaxInd>false</Form4720Filed4912TaxInd>
      <SubstantiallyAllDuesNondedInd>false</SubstantiallyAllDuesNondedInd>
      <OnlyInHouseLobbyingInd>false</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>true</AgreeCarryoverPriorYearInd>
      <DuesAssessmentsAmt>3247396</DuesAssessmentsAmt>
      <NonDeductibleLbbyngPltclCYAmt>1300524</NonDeductibleLbbyngPltclCYAmt>
      <NonDedLbbyngPltclCyovAmt>-1723</NonDedLbbyngPltclCyovAmt>
      <NonDeductibleLbbyngPltclTotAmt>1298801</NonDeductibleLbbyngPltclTotAmt>
      <AggregateReportedDuesNtcAmt>835652</AggregateReportedDuesNtcAmt>
      <CarriedOverAmt>464872</CarriedOverAmt>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="000000000000000000000000000003">
      <DisclosedOrgLegCtrlInd>false</DisclosedOrgLegCtrlInd>
      <DisclosedForCharitablePrpsInd>false</DisclosedForCharitablePrpsInd>
      <WrittenPolicyMonitoringInd>false</WrittenPolicyMonitoringInd>
      <Section170hRqrStsfdInd>false</Section170hRqrStsfdInd>
      <SolicitedAssetsSaleInd>false</SolicitedAssetsSaleInd>
      <AgentTrusteeEtcInd>false</AgentTrusteeEtcInd>
      <EndingBalanceAmt>0</EndingBalanceAmt>
      <InclEscrowCustodialAcctLiabInd>false</InclEscrowCustodialAcctLiabInd>
      <CYEndwmtFundGrp>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>false</RelatedOrgListSchRInd>
      <LandGrp>
        <BookValueAmt>0</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <BookValueAmt>0</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <BookValueAmt>0</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>325533</InvestmentCostOrOtherBasisAmt>
        <DepreciationAmt>252017</DepreciationAmt>
        <BookValueAmt>73516</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <BookValueAmt>0</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>73516</TotalBookValueLandBuildingsAmt>
      <TotalBookValueSecuritiesAmt>0</TotalBookValueSecuritiesAmt>
      <TotalBookValueProgramRltdAmt>0</TotalBookValueProgramRltdAmt>
      <TotalBookValueOtherAssetsAmt>0</TotalBookValueOtherAssetsAmt>
      <TotalLiabilityAmt>0</TotalLiabilityAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>0</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>0</TotalRevenuePerForm990Amt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>0</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>0</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="000000000000000000000000000004">
      <GrantRecordsMaintainedInd>false</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Supporters of NC Skilled Nursing Facilities</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>6325 Falls of Neuse Rd 35-259</AddressLine1Txt>
          <CityNm>Raleigh</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27615</ZIPCd>
        </USAddress>
        <RecipientEIN>999999999</RecipientEIN>
        <IRCSectionDesc>527</IRCSectionDesc>
        <CashGrantAmt>60000</CashGrantAmt>
      </RecipientTable>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="000000000000000000000000000005">
      <TravelForCompanionsInd>X</TravelForCompanionsInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RebuttablePresumptionProcInd>false</RebuttablePresumptionProcInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>James A Sholar</PersonNm>
        <BaseCompensationFilingOrgAmt>451193</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>343184</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>29435</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>35700</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>7223</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>866735</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>20655</CompReportPrior990FilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Samuel Clark</PersonNm>
        <BaseCompensationFilingOrgAmt>222893</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>25000</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>9916</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>15754</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>273563</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Karen O Lennon</PersonNm>
        <BaseCompensationFilingOrgAmt>126303</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>25000</BonusFilingOrganizationAmount>
        <NontaxableBenefitsFilingOrgAmt>9341</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>160644</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>990 Sched J Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>James A Sholar is granted a non-participatory 457(b) plan under his compensation contract</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="000000000000000000000000000006">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 Part VI Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Election of members and their rights; The members of the organization vote / elect the board of directors every 2 years</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 Part VI line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>Decisions subject to approval of members; the amount of dues are subject to the approval of the members of the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 Part Vi Line 8a</FormAndLineReferenceDesc>
        <ExplanationTxt>Documentation by committees; Although most committees do not consistently keep contemporaneous minutes, the committees report to the governing board and such reports are documented in the board minutes.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 Part VI Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Organization's process to review the 990; Form 990 is reviewed by the executive committee annually before filing. The executive committee has been delegated authority by the board of directors to act on behalf of the full board regarding the 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 Part IX, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Board members are required to review and sign a disclosure document regarding any such transactions or potential conflicts annually.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 Part VI, Section A, Line 15a and 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation for the upcoming year for the executive director is examined and set/approved by the executive committee annually. The executive director, as ratified by board approval, sets the compensation for other employees. Sources consulted are the 990s of other membership organizations, surveys of other healthcare facilities associations, and Bureau of Labor Statistics and Valuation Resources compensation data. The last review was in 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 Part VI Section C Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing documents disclosure; All referenced documents are available upon request and at the association's Raleigh location.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990 Part VI Line 8b</FormAndLineReferenceDesc>
        <ExplanationTxt>See answer above for Line 8a</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>