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        <ExplanationTxt>OTHER SUPPORT THE EXPENSES INCURRED BY HH MEDSTAR HEALTH, INC. THAT ARE REPORTED ON FORM 990, PART IX WERE EXPENDED TO PROVIDE SUPPORT AND MANAGEMENT SERVICES TO ITS SUPPORTED ORGANIZATIONS.</ExplanationTxt>
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        <PersonNm>OLIVER TANNOUS</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <PersonNm>ATUL SHAH</PersonNm>
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        <PersonNm>MICHAEL J CURRAN</PersonNm>
        <TitleTxt>FORMER TREASURER</TitleTxt>
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        <PersonNm>RICHARD GOLDBERG</PersonNm>
        <TitleTxt>FORMER MMG PRESIDENT</TitleTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>MR. SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B)(III) INCLUDES A PAYMENT OF $1,372,432, WHICH REPRESENTS THE CASH VALUE OF THE SPLIT DOLLAR LIFE INSURANCE POLICY ASSIGNED TO MR. SAMET. ERIC WAGNER'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B)(III) INCLUDES $429,576 REPRESENTING SEVERANCE PAYMENTS RECEIVED BY MR. WAGNER.</ExplanationTxt>
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    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MISSION OF MEDSTAR HEALTH, INC. (MEDSTAR HEALTH), A MARYLAND CORPORATION, IS TO SERVE OUR PATIENTS, THOSE WHO CARE FOR THEM AND OUR COMMUNITIES. MEDSTAR HEALTH IS THE CONTROLLING ENTITY OF AN INTEGRATED HEALTH SERVICES ORGANIZATION (THE SYSTEM) OFFERING A WIDE VARIETY OF HEALTHCARE SERVICES TO RESIDENTS OF MARYLAND AND THE WASHINGTON, D.C., REGION (COMPRISING BALTIMORE CITY, ELEVEN COUNTIES IN MARYLAND, THE DISTRICT OF COLUMBIA, AND NORTHERN VIRGINIA). MEDSTAR HEALTH IS THE REGION'S LARGEST HEALTH SYSTEM AND ONE OF THE LARGEST EMPLOYERS IN MARYLAND AND WASHINGTON, D.C., WITH APPROXIMATELY 35,000 ASSOCIATES AND 4,000 AFFILIATED PHYSICIANS. THE SYSTEM OPERATES THE LARGEST HOME HEALTH BUSINESS IN THE REGION WITH APPROXIMATELY 315,400 VISITS IN FISCAL YEAR 2024. MEDSTAR FAMILY CHOICE, A MEDICAID MANAGED CARE COMPANY, HAD APPROXIMATELY 157,000 COVERED LIVES AS OF JUNE 30, 2024. IN FISCAL YEAR 2024, MEDSTAR HEALTH HOSPITALS HAD APPROXIMATELY 118,900 INPATIENT ADMISSIONS AND OBSERVATION CASES AND APPROXIMATELY 6.1 MILLION OUTPATIENT VISITS, INCLUDING APPROXIMATELY 428,300 EMERGENCY VISITS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION MEMBERS THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION OF MEMBERS AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT &amp; CEO OF MEDSTAR HEALTH, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>APPROVAL OF DECISIONS OF THE GOVERNING BODY AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS FOR REVIEWING FORM 990 THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST POLICY APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO DETERMINES HOW THE MATTER SHOULD BE RESOLVED. IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC).</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>EXECUTIVE COMPENSATION POLICY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM.THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE (TAX-EXEMPT HEALTHCARE ORGANIZATIONS). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST &amp; YOUNG LLP ("E&amp;Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&amp;Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&amp;Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&amp;Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCIAL STATEMENT AVAILABILITY MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>EQUITY TRANSFERS 3,025,989. ADDITIONAL MINIMUM PENSION LIABILITY 45,699,497.</ExplanationTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <AddressLine1Txt>5601 LOCH RAVEN BLVD</AddressLine1Txt>
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          <StateAbbreviationCd>MD</StateAbbreviationCd>
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      <IdRelatedTaxExemptOrgGrp>
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          <StateAbbreviationCd>MD</StateAbbreviationCd>
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          <BusinessNameLine1Txt>MEDSTAR VNA HEALTHCARE</BusinessNameLine1Txt>
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          <StateAbbreviationCd>MD</StateAbbreviationCd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>MGH WOMEN'S BOARD</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>NATIONAL REHABILITATION HOSPITAL</BusinessNameLine1Txt>
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          <AddressLine1Txt>102 IRVING STREET NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
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        <EIN>521369749</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>REGIONAL REHAB AT OLNEY INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>18101 PRINCE PHILIP DRIVE</AddressLine1Txt>
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          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20832</ZIPCd>
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        <EIN>522310902</EIN>
        <PrimaryActivitiesTxt>MEDICAL SVCS</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>SUBURBAN NRH MEDICAL REHABILITATION I</BusinessNameLine1Txt>
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          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
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        <EIN>521931151</EIN>
        <PrimaryActivitiesTxt>MEDICAL SVCS</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>VNA INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>4061 POWDERMILL ROAD SUITE 210</AddressLine1Txt>
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          <ZIPCd>20705</ZIPCd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>WOODBOURNE WOODS INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>5601 LOCH RAVEN BLVD</AddressLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>HOSPICE OF ST MARY'S INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>PO BOX 527</AddressLine1Txt>
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          <AddressLine1Txt>25500 POINT LOOKOUT ROAD</AddressLine1Txt>
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          <AddressLine1Txt>24035 THREE NOTCH ROAD</AddressLine1Txt>
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        <RelatedOrganizationName>
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          <AddressLine1Txt>7253 AMBASSADOR RD</AddressLine1Txt>
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          <BusinessNameLine1Txt>10 ST PATRICK'S DRIVE LLC</BusinessNameLine1Txt>
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          <AddressLine1Txt>10 ST PATRICKS DRIVE</AddressLine1Txt>
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          <AddressLine1Txt>6475 NEW HAMPSHIRE AVE</AddressLine1Txt>
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        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
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      <IdRelatedOrgTxblPartnershipGrp>
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          <BusinessNameLine1Txt>MEDSTAR ENDOSCOPY CENTER-SILVER SPRING LLC</BusinessNameLine1Txt>
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          <CityNm>SILVER SPRING</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20906</ZIPCd>
        </USAddress>
        <EIN>872341245</EIN>
        <PrimaryActivitiesTxt>SURGERY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>N/A</PredominantIncomeTypeTxt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR SURGERY CENTER 1 LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>810 BESTGATE ROAD SUITE 300</AddressLine1Txt>
          <CityNm>ANNAPOLIS</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21401</ZIPCd>
        </USAddress>
        <EIN>922094391</EIN>
        <PrimaryActivitiesTxt>SURGERY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>N/A</PredominantIncomeTypeTxt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR SURGERY CENTER AT BRANDYWINE LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>13950 BRANDYWINE ROAD</AddressLine1Txt>
          <CityNm>BRANDYWINE</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20613</ZIPCd>
        </USAddress>
        <EIN>820985178</EIN>
        <PrimaryActivitiesTxt>SURGERY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>N/A</PredominantIncomeTypeTxt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR SURGERY CENTER AT TIMONIUM LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2118 GREENSPRING DRIVE STE 300</AddressLine1Txt>
          <CityNm>TIMONIUM</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21093</ZIPCd>
        </USAddress>
        <EIN>821874292</EIN>
        <PrimaryActivitiesTxt>SURGERY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>N/A</PredominantIncomeTypeTxt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR PHARMACIES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>521513056</EIN>
        <PrimaryActivitiesTxt>DRUG SALES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>11011532</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>5022226</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EXTENCARE INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>521556228</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>356443</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>2285022</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HELIX RESOURCES MANAGEMENT INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>521913070</EIN>
        <PrimaryActivitiesTxt>ADMIN SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>-16296</ShareOfTotalIncomeAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HELIXCARE PROPERTIES LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>521966695</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PARKWAY VENTURES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>521893569</EIN>
        <PrimaryActivitiesTxt>HOLDING COMPANY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>163820614</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>299012842</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PHYSICIANS ADMINISTRATIVE SERVICES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>237042074</EIN>
        <PrimaryActivitiesTxt>BILLING SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR FAMILY CHOICE INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>521995521</EIN>
        <PrimaryActivitiesTxt>MANAGED CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>994072996</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>360180676</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR ENTERPRISES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>4061 POWDERMILL ROAD SUITE 210</AddressLine1Txt>
          <CityNm>CALVERTON</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20705</ZIPCd>
        </USAddress>
        <EIN>522139841</EIN>
        <PrimaryActivitiesTxt>ADMIN SERVICE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SITEL INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>900753340</EIN>
        <PrimaryActivitiesTxt>EDUCATIONAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>STAR BILLING INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>4061 POWDERMILL ROAD SUITE 210</AddressLine1Txt>
          <CityNm>CALVERTON</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20705</ZIPCd>
        </USAddress>
        <EIN>521850113</EIN>
        <PrimaryActivitiesTxt>BILLING SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>WASHINGTON RISK NETWORK MANAGEMENT INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>4061 POWDERMILL ROAD SUITE 210</AddressLine1Txt>
          <CityNm>CALVERTON</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20705</ZIPCd>
        </USAddress>
        <EIN>522132677</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>WASHINGTON HOSPITAL CENTER PHYSICIAN HOS</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>100 IRVING STREET NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>521931000</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR PHYSICIAN PARTNERS INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>4061 POWDERMILL ROAD SUITE 210</AddressLine1Txt>
          <CityNm>CALVERTON</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20705</ZIPCd>
        </USAddress>
        <EIN>522030809</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>FRANKLIN SQUARE DRIVE LAND CONDO ASSOCIA</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>10980 GRANTCHESTER WAY</AddressLine1Txt>
          <CityNm>COLUMBIA</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21044</ZIPCd>
        </USAddress>
        <EIN>760756352</EIN>
        <PrimaryActivitiesTxt>CONDOMINIUMS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MGH DIVERSIFIED SERVICES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>18101 PRINCE PHILIP DRIVE</AddressLine1Txt>
          <CityNm>OLNEY</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20832</ZIPCd>
        </USAddress>
        <EIN>521943602</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>GREENSPRING FINANCIAL INSURANCE LIMITED</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>878 WEST BAY RD PO BOX 1159</AddressLine1Txt>
          <CityNm>GRAND CAYMAN</CityNm>
          <CountryCd>CJ</CountryCd>
          <ForeignPostalCd>KY1-1102</ForeignPostalCd>
        </ForeignAddress>
        <EIN>980188617</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ST MARY'S HEALTH ALLIANCE INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>25500 POINT LOOKOUT ROAD</AddressLine1Txt>
          <CityNm>LEONARDTOWN</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20650</ZIPCd>
        </USAddress>
        <EIN>521930331</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ST MARY'S CONDO ASSOCIATION</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>25500 POINT LOOKOUT RD</AddressLine1Txt>
          <CityNm>LEONARDTOWN</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>20650</ZIPCd>
        </USAddress>
        <EIN>273377216</EIN>
        <PrimaryActivitiesTxt>CONDOMINIUMS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR HEALTH INC - INVESTMENT FUND I</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>103 SOUTH CHURCH ST</AddressLine1Txt>
          <CityNm>GRAND CAYMAN</CityNm>
          <CountryCd>CJ</CountryCd>
          <ForeignPostalCd>KY1-1002</ForeignPostalCd>
        </ForeignAddress>
        <EIN>981310273</EIN>
        <PrimaryActivitiesTxt>INVESTMENTS</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <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>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>HELIX FINANCIAL INSURANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>897805</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>EXTENCARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>750569</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MEDSTAR PHARMACIES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>2457661</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>