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        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
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        <FPGFamilyIncmLmtDscntCarePct>400.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>WWW.LEXMED.COM/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>SAME AS ABOVE</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>SAME AS ABOVE</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>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>LEXINGTON HEALTH INC DBA LEXINGTON MEDICAL CENTER</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 3J: OUR STATEMENT INCLUDES A COPY OF OUR FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY WITH THE FOLLOWING INFORMATION: HOW TO APPLY, DETERMINATION OF ELIGIBILITY, AND INFORMATION AND ASSISTANCE REGARDING THE FAP PROGRAM.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>LEXINGTON HEALTH INC DBA LEXINGTON MEDICAL CENTER</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: IN ADDITION TO THE PHYSCIAL SURVEY LEXINGTON HEALTH INC CONDUCTED (14) KEY INFORMANT INTERVIEWS AND (1) FOCUS GROUP. THE INTENTION OF THE LATTER TWO METHODS WERE TO ADD CONTEXT TO THE SURVEY DATA. BELOW ARE THE INDIVIDUALS WE INTERVIEWED.SARA FAWCETT, PRESIDENT/CEO OF UNITED WAY OF THE MIDLANDSTOD AUGSBURGER, PRESIDENT/CEO OF LEXINGTON HEALTH INC.ANGELLE LABRODE, PRESIDENT/CEO OF LEXINGTON CHAMBER OF COMMERCEJAY KOON, SHERIFF OF LEXINGTON COUNTY POLICE DEPARTMENTDEBBIE SUMMERS, COUNCILWOMAN OF LEXINGTON COUNTY COUNCILCARL BLACKSTONE, PRESIDENT/CEO OF COLUMBIA CHAMBER OF COMMERCEJULIE ANN AVIN, EXECUTIVE DIRECTOR OF MIRCITOM LEDBETTER, AVP OF MIDLANDS TECHPAMELA BYNOE-REED, DIRECTOR OF MARKETING OF CENTRAL MIDLANDS REGIONAL TRANSIT AUTHORITYMARIA OWENS, STRATEGIC PARTNERSHIPS DIRECTOR OF RICHLAND COUNTY SCHOOL DISTRICT 2ROBIN COOPER, HEALTH EDUCATOR - MIDLANDS OF SC DHECGREG FROHNAPPEL, LEXINGTON COUNTY DIRECTOR OF SC DSS - LEXINGTON COUNTYLARRY SALLEY, EXECUTIVE DIRECTOR OF GREATER COLUMBIA COMMUNITY RELATIONS COUNCILBRYANT DAVIS, ASSISTANT DIRECTOR OF GOVERNMENT AND COMMUNITY SERVICES OF RICHLAND COUNTY</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>LEXINGTON HEALTH INC DBA LEXINGTON MEDICAL CENTER</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6A: LEXINGTON HEALTH INC. PARTNERED WITH THE MEDICAL UNIVERSITY OF SOUTH CAROLINA TO CONDUCT THE 2022 CHNA.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>LEXINGTON HEALTH INC DBA LEXINGTON MEDICAL CENTER</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6B: LEXINGTON HEALTH INC ALSO PARTNERED WITH THE ALLIANCE FOR A HEALTHIER SOUTH CAROLINA AND THE SOUTH CAROLINA DEPARTMENT FOR HEALTH AND ENVIRONMENTAL CONTROL.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>LEXINGTON HEALTH INC DBA LEXINGTON MEDICAL CENTER</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: LISTED BELOW ARE PROGRAMS THAT HAVE BEEN IMPLEMENTED THUS FAR TO ADDRESS THE PRIORITIZED HEALTH NEEDS.ACCESS TO CARE AND CLINICAL PREVENTIVE SERVICES- WE OFFER FREE FLU VACCINES, COVID-19 VACCINES, BIOMETRIC SCREENINGS, SMOKING CESSATION, AND CANCER SCREENINGS TO THE COMMUNITY. LEXINGTON MEDICAL CENTER IMPLEMENTED ITS PRIMARY CARE CONNECT PROGRAM TO ASSIST PATIENTS WITH FINDING A PRIMARY CARE PROVIDER- SINGLE NUMBER TO CALL THAT HAS ACCESS TO ALL PROVIDERS AND CAN SCHEDULE APPOINTMENT WITH A PROVIDER ACCEPTING NEW PATIENTS. IN FEBRUARY OF 2023 WE IMPLEMENTED UNITE US, A SOCIAL DETERMINANTS OF HEALTH PLATFORM THAT INTEGRATES INTO OUR EMR. IT COORDINATES ELECTRONIC REFERRALS AND CASES MANAGEMENT TASKS BETWEEN HEALTH AND SOCIAL SERVICE ORGANIZATIONS ON A COMMON PLATFORM. CLOSES THE LOOP ON REFERRALS AND OUTCOMES TO ENSURE PROPER ACCESS TO CARE. OBESITY AND DIABETES- ASSISTED HARVEST HOPE WITH FUNDING, PREPARATION AND DISTRIBUTION OF DIABETIC FOOD FRIENDLY BOXES FOR RESIDENTS IN LEXINGTON COUNTY. PROVIDED OVER 16,000 DIABETIC FRIENDLY MEALS SINCE 2022.MENTAL HEALTH- LMC IS THE DRIVING FORCE IN THE CREATION OF UPLIFT LEXINGTON COUNTY. THIS IS A COLLABORATIVE COALITION TO INCREASE ACCESS TO MENTAL HEALTH CARE IN LEXINGTON COUNTY. COALITION PARTNERS INCLUDE LEXINGTON COUNTY COMMUNITY MENTAL HEALTH, SERVE AND CONNECT, LEXINGTON COUNTY SHERIFF'S DEPARTMENT, AND LEXINGTON COUNTY EMERGENCY MEDICAL SERVICES. IT RECEIVED A DUKE ENDOWMENT GRANT FOR 3 YEARS TOTALING $980,000. LMC RECEIVED FUNDING FOR THE ESTABLISHMENT OF AN EMPATH UNIT DESIGNED AND STAFFED TO TREAT ALL EMERGENCY PSYCHIATRIC PATIENTS, NO EXCLUSIONS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GROSS ANNUAL INCOME OF THE APPLICANT AND FAMILY IS MEASURED AGAINST THE ANNUAL POVERTY GUIDELINES FOR THE APPROPRIATE SIZE FAMILY. GROSS ANNUAL INCOME SHOULD BE REPRESENTATIVE OF THE FAMILY'S AVERAGE EARNINGS. FOR THIS REASON, THE METHOD OF CALCULATING GROSS ANNUAL INCOME WILL VARY DEPENDENT UPON THE EMPLOYMENT STATUS OF THE FAMILY MEMBERS. THE FOLLOWING METHODS MAY BE USED TO COMPUTE GROSS ANNUAL INCOME BASED ON THE MANNER IN WHICH THE INCOME IS RECEIVED: FIXED MONTHLY INCOME; HOURLY/SALARY WITH BONUSES, COMMISSIONS, AND OVERTIME; IRREGULAR INCOME; SELF-EMPLOYMENT INCOME; AND INABILITY TO WORK</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>LHI IS COMMITTED TO HELPING PATIENTS UNDERSTAND AND MANAGE THE COST OF SERVICES BEFORE THOSE SERVICES ARE DELIVERED. LHI EPXECTS PATIENTS, GUARANTORS OR THEIR THIRD PARTY INSURERS TO PAY IN FULL FOR SERVICES PROVIDED. LHI WILL BILL THIRD PARTY INSURERS IN ACCORDANCE WITH THE REQUIREMENTS OF APPLICABLE LAW, CONTRACTS WITH THIRD PARTY INSURERS AND APPLICABLE BILLING GUIDELINES. A PATIENT'S FAILURE TO PAY OR MAKE SATISFACTORY FINANCIAL ARRANGEMENTS WILL RENDER THE ACCOUNT DELINQUENT. LHI RESERVES THE RIGHT TO TAKE COLLECTION ACTIONS AS PERMITTED BY LAW AND THIS POLICY CONCERNING BALANCES DUE FROM EITHER THE PATIENT OR THIRD PARTY INSURERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENTS WHO ARE COVERED BY THIRD PARTY PAYERS ARE RESPONSIBLE FOR PATIENT RESPONSIBILITY BALANCES, INCLUDING DEDUCTIBLES AND CO-INSURANCE, WHICH VARY IN AMOUNT. LHI ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY EXPLICIT PRICE CONCESSIONS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAS DEBT EXPENSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>LEXINGTON HEALTH, INC WILL USE THE SAME REASONABLE COLLECTION EFFORTS AND PROCESSES FOR COLLECTING AMOUNTS DUE FOR SERVICES PROVIDED TO ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. COLLECTION ACTIVITIES WILL CONTINUE UNTIL AN ACCOUNT BALANCE IS PAID IN FULL, OR AN ACCOUNT IS SECURED BY A PROTECTED STATUS, I.E. PAYMENT PLANS, PAYROLL DEDUCTIONS, LEGAL ACCOUNTS WITH LETTERS OF PROTECTION, ETC. IF NO ACTIVITY HAS TAKEN PLACE FOR A MINIMUM OF THREE MONTHS, COLLECTION EFFORTS WILL PROGRESS.</ExplanationTxt>
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        <OtherCompensationFilingOrgAmt>2806</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>132736</DeferredCompensationFlngOrgAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <RelationshipDescriptionTxt>BOARD MEMBER OF RELATED ORGANIZATION IS EMPLOYEE OF PROVIDER</RelationshipDescriptionTxt>
        <TransactionAmt>237000</TransactionAmt>
        <TransactionDesc>SOCIAL MEDIA MONITORING AND ANALYTICS SERVICES PROVIDED</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>DR JOHN SPALDING</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>BOARD MEMBER OF RELATED ORGANIZATION IS EMPLOYEE OF PROVIDER</RelationshipDescriptionTxt>
        <TransactionAmt>1004500</TransactionAmt>
        <TransactionDesc>CONTRACTED WITH PROVIDER FOR PATHOLOGISTS AND OTHER MEDICAL SERVICES</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>THAD WESTBROOK</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>BOARD MEMBER OF RELATED ORGANIZATION IS PARTNER OF PROVIDER</RelationshipDescriptionTxt>
        <TransactionAmt>304785</TransactionAmt>
        <TransactionDesc>ATTORNEY SERVICES PROVIDED</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIOR TO FILING FORM 990, THE RETURN IS PROVIDED TO THE BOARD FOR REVIEW AND PRESENTED AT THE MONTHLY BOARD MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>LEXINGTON HEALTH, INC REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH THEIR CORPORATE COMPLIANCE OFFICER AND HOTLINE (ANONYMOUS TIPS).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>LEXINGTON HEALTH, INC CONTRACTS WITH AN INDEPENDENT CONSULTANT TO RESEARCH SALARIES FOR DIRECTORS AND KEY EMPLOYEES. THEN THE BOARD DETERMINES THE SALARIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSFER OF ASSETS FROM LEXINGTON COUNTY HEALTH SERVICES DISTRICT 2,620,573. OTHER DECREASES IN NET ASSETS WITH DONOR RESTRICTIONS -838,643.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>NO CHANGES TO OVERSIGHT PROCESS IN THE CURRENT YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>LEXMED INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>815 OLD CHEROKEE RD</AddressLine1Txt>
          <CityNm>LEXINGTON</CityNm>
          <StateAbbreviationCd>SC</StateAbbreviationCd>
          <ZIPCd>29072</ZIPCd>
        </USAddress>
        <EIN>570874078</EIN>
        <PrimaryActivitiesTxt>CONGREGATE CARE AND OTHER HEALTHCARE RELATED FACILITY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>SC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LEXINGTON HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>LEXINGTON MEDICAL CENTER FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2720 SUNSET BLVD</AddressLine1Txt>
          <CityNm>WEST COLUMBIA</CityNm>
          <StateAbbreviationCd>SC</StateAbbreviationCd>
          <ZIPCd>29169</ZIPCd>
        </USAddress>
        <EIN>570906045</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING ENTITY THAT BENEFITS AND PROMOTES LEXINGTON HEALTH INC.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>SC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LEXINGTON HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PALMETTO HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2720 SUNSET BLVD</AddressLine1Txt>
          <CityNm>WEST COLUMBIA</CityNm>
          <StateAbbreviationCd>SC</StateAbbreviationCd>
          <ZIPCd>29169</ZIPCd>
        </USAddress>
        <EIN>570779601</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>SC</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LEXINGTON HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>126911</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>25007</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>LEXINGTON HEALTH LIABILITY SERVICES LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2720 SUNSET BLVD</AddressLine1Txt>
          <CityNm>WEST COLUMBIA</CityNm>
          <StateAbbreviationCd>SC</StateAbbreviationCd>
          <ZIPCd>29169</ZIPCd>
        </USAddress>
        <EIN>872565711</EIN>
        <PrimaryActivitiesTxt>CAPTIVE INSURANCE COMPANY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>SC</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LEXINGTON HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>1288143</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>12685712</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</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>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>LEXINGTON MEDICAL CENTER FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>748280</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>LEXINGTON MEDICAL CENTER FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>1591250</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
