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      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>718000</TotalAmt>
        <ProgramServicesAmt>502600</ProgramServicesAmt>
        <ManagementAndGeneralAmt>215400</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>961406</TotalAmt>
        <ProgramServicesAmt>672984</ProgramServicesAmt>
        <ManagementAndGeneralAmt>288422</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>108340</TotalAmt>
        <ProgramServicesAmt>75838</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32502</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>134650</TotalAmt>
        <ProgramServicesAmt>94255</ProgramServicesAmt>
        <ManagementAndGeneralAmt>40395</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>90718</TotalAmt>
        <ProgramServicesAmt>63503</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27215</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>387035</TotalAmt>
        <ProgramServicesAmt>313498</ProgramServicesAmt>
        <ManagementAndGeneralAmt>73537</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>82508</TotalAmt>
        <ManagementAndGeneralAmt>82508</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising></FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>0</TotalAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>189673</TotalAmt>
        <ProgramServicesAmt>132561</ProgramServicesAmt>
        <ManagementAndGeneralAmt>56812</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>55590</TotalAmt>
        <ProgramServicesAmt>39123</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16767</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>78754</TotalAmt>
        <ProgramServicesAmt>39377</ProgramServicesAmt>
        <ManagementAndGeneralAmt>39377</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>70473</TotalAmt>
        <ProgramServicesAmt>67839</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2634</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>0</TotalAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>120000</TotalAmt>
        <ProgramServicesAmt>120000</ProgramServicesAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>26773</TotalAmt>
        <ProgramServicesAmt>13387</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13386</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>0</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>AHCA dues</Desc>
        <TotalAmt>855990</TotalAmt>
        <ProgramServicesAmt>855990</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Other meetings / seminars</Desc>
        <TotalAmt>661069</TotalAmt>
        <ProgramServicesAmt>661069</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Pass-through donation</Desc>
        <TotalAmt>40731</TotalAmt>
        <ProgramServicesAmt>40731</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>4581710</TotalAmt>
        <ProgramServicesAmt>3692755</ProgramServicesAmt>
        <ManagementAndGeneralAmt>888955</ManagementAndGeneralAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>305258</BOYAmt>
        <EOYAmt>213377</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>2885106</BOYAmt>
        <EOYAmt>2381405</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>263055</BOYAmt>
        <EOYAmt>4142520</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>62885</BOYAmt>
        <EOYAmt>62672</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>325553</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>247772</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>77781</BOYAmt>
        <EOYAmt>55318</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>1551772</BOYAmt>
        <EOYAmt>2750455</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <TotalAssetsGrp>
        <BOYAmt>5145857</BOYAmt>
        <EOYAmt>9605747</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>160901</BOYAmt>
        <EOYAmt>226199</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>442245</BOYAmt>
        <EOYAmt>3762375</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>603146</BOYAmt>
        <EOYAmt>3988574</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>4416294</BOYAmt>
        <EOYAmt>5233304</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>126417</BOYAmt>
        <EOYAmt>383869</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>4542711</BOYAmt>
        <EOYAmt>5617173</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>5145857</BOYAmt>
        <EOYAmt>9605747</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>1074462</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>true</AccountantCompileOrReviewInd>
      <AcctCompileOrReviewBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </AcctCompileOrReviewBasisGrp>
      <FSAuditedInd>false</FSAuditedInd>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleC documentId="990C" softwareId="24019898" softwareVersionNum="24.0.1.0">
      <DuesAssessmentsAmt>3926308</DuesAssessmentsAmt>
      <NonDeductibleLbbyngPltclCYAmt>1249712</NonDeductibleLbbyngPltclCYAmt>
      <NonDedLbbyngPltclCyovAmt>464872</NonDedLbbyngPltclCyovAmt>
      <NonDeductibleLbbyngPltclTotAmt>1714584</NonDeductibleLbbyngPltclTotAmt>
      <AggregateReportedDuesNtcAmt>999270</AggregateReportedDuesNtcAmt>
      <CarriedOverAmt>715314</CarriedOverAmt>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="990D" softwareId="24019898" softwareVersionNum="24.0.1.0">
      <InclEscrowCustodialAcctLiabInd>false</InclEscrowCustodialAcctLiabInd>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>329863</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>274545</DepreciationAmt>
        <BookValueAmt>55318</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>55318</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>Financial derivatives and other financial products</Desc>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Closely-held equity interests</Desc>
      </OtherSecuritiesGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Federal income taxes</Desc>
      </OtherLiabilitiesOrgGrp>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="990J" softwareId="24019898" softwareVersionNum="24.0.1.0">
      <TravelForCompanionsInd>X</TravelForCompanionsInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>James A Sholar</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>527000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>191000</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>29999</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>36800</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>7834</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>792633</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Samuel Clark</PersonNm>
        <TitleTxt>VP Finance</TitleTxt>
        <BaseCompensationFilingOrgAmt>232672</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>25000</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>10307</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>15189</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>283168</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Karen O Lennon</PersonNm>
        <TitleTxt>VP Education member services</TitleTxt>
        <BaseCompensationFilingOrgAmt>133206</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>50000</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>7328</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8747</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>199281</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>James A Sholar is granted a non-participatory 457b plan under his compensation contract</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="990O" softwareId="24019898" softwareVersionNum="24.0.1.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Election of board 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>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>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>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 o 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/b</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 the board approvals, sets the compensation for other employees. Sources consulted are the 990s of other membership organizations, surveys of other healthcare facilities associations, and BLS and BVR compensation data. The last review was in 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All referenced documents are available on request and at the Associations 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>