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        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>17185</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>453113</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DAVID NOE</NamePerson>
        <Title>VP</Title>
        <BaseCompensationFilingOrg>334251</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>152746</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>12535</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>14953</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>13232</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>527717</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>BRUCE BARTOO</NamePerson>
        <Title>VP</Title>
        <BaseCompensationFilingOrg>306029</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>135187</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>18207</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>459423</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JEAN HITCHCOCK</NamePerson>
        <Title>VP</Title>
        <BaseCompensationFilingOrg>314447</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>135227</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>5622</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>8900</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>464196</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>EDWARD ROBINSON</NamePerson>
        <Title>VP</Title>
        <BaseCompensationFilingOrg>325714</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>150126</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>17742</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>493582</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>SOCIAL CLUB DUES</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 1A</ReturnReference>
        <Explanation>THE ORGANIZATION PAID SOCIAL CLUB DUES FOR THREE OF ITS OFFICERS DURING THIS YEAR. PARTICIPATION IN THESE ACTIVITIES BY THE OFFICERS WAS FOR BUSINESS PURPOSES, AND HELPED THE ORGANIZATION FURTHER ITS EXEMPT PURPOSES.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>OTHER REPORTABLE COMPENSATION</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINES 4A AND 4B</ReturnReference>
        <Explanation>KENNETH SAMET, MICHAEL CURRAN, AND WILLIAM THOMAS Mssrs. Samet, Curran, and Thomas' Other reportable compensation in Part II, Column (B) (iii) includes $928,678, $430,836, and $597,402 respectively, representing their benefits received from supplemental retirement plans, which were earned during the past 24, 12, and 18 years of service respectively. A portion of these amounts, $208,524, $51,445, and $143,158, respectively, was also reported on Form 990 in prior years. ROBERT RYAN Robert Ryan's Other reportable compensation in Part II, Column (B) (iii) includes $57,944 relating to income realized in the current year on the appreciation of certain investments that were granted to Mr. Ryan in prior years and which related to services performed in prior years.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <Form990ScheduleKPartI>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>520936091</IssuerEIN>
        <CUSIPNumber>574217MW2</CUSIPNumber>
        <DateIssued>2004-02-03</DateIssued>
        <IssuePrice>168903885</IssuePrice>
        <DescriptionOfPurpose>ADVANCE REFUND BONDS ISSUED 2001</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>520936091</IssuerEIN>
        <CUSIPNumber>574217c60</CUSIPNumber>
        <DateIssued>2007-01-31</DateIssued>
        <IssuePrice>148551201</IssuePrice>
        <DescriptionOfPurpose>CONSTRUCT FRANKLIN SQ. HOSPITAL TO</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>DISTRICT OF COLUMBIA</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>536001131</IssuerEIN>
        <CUSIPNumber>2548393Y7</CUSIPNumber>
        <DateIssued>2008-05-15</DateIssued>
        <IssuePrice>283137423</IssuePrice>
        <DescriptionOfPurpose>CURRENT REFUND BONDS ISSUED 1998</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <BondReferenceCd>D</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>520936091</IssuerEIN>
        <CUSIPNumber>5742180Y6</CUSIPNumber>
        <DateIssued>2011-11-17</DateIssued>
        <IssuePrice>47805502</IssuePrice>
        <DescriptionOfPurpose>CURRENT REFUND BANK DEBT</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <BondReferenceCd>A</BondReferenceCd>
        <AmountRetired>7025000</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>168903885</TotalProceeds>
        <AmountInReserveFund>188821</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>166098335</RefundingEscrow>
        <IssuanceCostsFromProceeds>2616729</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>0</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <YearOfSubstCompletion>2001</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>true</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <BondReferenceCd>B</BondReferenceCd>
        <AmountRetired>0</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>148551201</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>1801484</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>146749717</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <YearOfSubstCompletion>2010</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <BondReferenceCd>C</BondReferenceCd>
        <AmountRetired>14200000</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>283137423</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>283137423</RefundingEscrow>
        <IssuanceCostsFromProceeds>0</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>0</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <YearOfSubstCompletion>1998</YearOfSubstCompletion>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <BondReferenceCd>D</BondReferenceCd>
        <AmountRetired>47171175</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>47805502</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>634327</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>0</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <YearOfSubstCompletion>2011</YearOfSubstCompletion>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>A</BondReferenceCd>
        <PrcntgePrvtBusinessUseByOthers>0</PrcntgePrvtBusinessUseByOthers>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <PrcntgeBondFinancedProp>0.00000</PrcntgeBondFinancedProp>
        <RemedialActionTaken>false</RemedialActionTaken>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>C</BondReferenceCd>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <PrcntgeBondFinancedProp>0.00000</PrcntgeBondFinancedProp>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>D</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0</PrcntgePrvtBusinessUseByOthers>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <RemedialActionTaken>false</RemedialActionTaken>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiled>true</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiled>false</Form8038TFiled>
        <NoRebateDue>true</NoRebateDue>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiled>false</Form8038TFiled>
        <RebateNotDueYet>true</RebateNotDueYet>
        <VariableRateIssue>true</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>D</BondReferenceCd>
        <Form8038TFiled>false</Form8038TFiled>
        <RebateNotDueYet>true</RebateNotDueYet>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>A</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>B</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>C</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>D</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
    </IRS990ScheduleK>
    <IRS990ScheduleK documentId="IRS990ScheduleKN1">
      <Form990ScheduleKPartI>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>520936091</IssuerEIN>
        <CUSIPNumber>5742180Y6</CUSIPNumber>
        <DateIssued>2011-11-17</DateIssued>
        <IssuePrice>20477518</IssuePrice>
        <DescriptionOfPurpose>CURRENT REFUND BONDS ISSUED 1998</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>520936091</IssuerEIN>
        <CUSIPNumber>5742180Y6</CUSIPNumber>
        <DateIssued>2011-11-17</DateIssued>
        <IssuePrice>15007304</IssuePrice>
        <DescriptionOfPurpose>CURRENT REFUND BONDS ISSUED 2002</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>520396091</IssuerEIN>
        <CUSIPNumber>5742180Y6</CUSIPNumber>
        <DateIssued>2011-11-17</DateIssued>
        <IssuePrice>15206131</IssuePrice>
        <DescriptionOfPurpose>CURRENT REFUND BONDS ISSUED 2009</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <BondReferenceCd>D</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>520936091</IssuerEIN>
        <CUSIPNumber>999999999</CUSIPNumber>
        <DateIssued>2012-06-27</DateIssued>
        <IssuePrice>38620000</IssuePrice>
        <DescriptionOfPurpose>CURRENT REFUND BONDS ISSUED 1998</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <BondReferenceCd>A</BondReferenceCd>
        <AmountRetired>20235000</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>20477518</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>242518</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>0</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <BondReferenceCd>B</BondReferenceCd>
        <AmountRetired>14826474</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>15007304</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>180830</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>0</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <BondReferenceCd>C</BondReferenceCd>
        <AmountRetired>15003890</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
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        <CapitalizedInterest>0</CapitalizedInterest>
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        <IssuanceCostsFromProceeds>202241</IssuanceCostsFromProceeds>
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        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>0</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
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        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
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        <BondReferenceCd>D</BondReferenceCd>
        <AmountRetired>0</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
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        <RefundingEscrow>0</RefundingEscrow>
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        <FinalAllocationMade>true</FinalAllocationMade>
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        <PrcntgePrvtBusinessUseByOthers>0</PrcntgePrvtBusinessUseByOthers>
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        <BondReferenceCd>B</BondReferenceCd>
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        <BondReferenceCd>C</BondReferenceCd>
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        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
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        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
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        <BondReferenceCd>A</BondReferenceCd>
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        <BondReferenceCd>A</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
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        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
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        <BondReferenceCd>C</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
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        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
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    <IRS990ScheduleK documentId="IRS990ScheduleKN2">
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        <DescriptionOfPurpose>FINANCE ACQUISITION OF SOUTHERN MA</DescriptionOfPurpose>
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        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
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        <BondReferenceCd>B</BondReferenceCd>
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        <FinalAllocationMade>true</FinalAllocationMade>
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        <BondReferenceCd>C</BondReferenceCd>
        <AmountRetired>0</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>159366620</TotalProceeds>
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        <AmountUnspent>0</AmountUnspent>
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        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
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        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <RemedialActionTaken>false</RemedialActionTaken>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
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        <BondReferenceCd>B</BondReferenceCd>
        <PrcntgePrvtBusinessUseByOthers>0</PrcntgePrvtBusinessUseByOthers>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>true</MngmentCntrctBondFinancdPrprty>
        <EngageBondCounselContracts>true</EngageBondCounselContracts>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00100</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00100</TotalPrivateBusinessUse>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <RemedialActionTaken>false</RemedialActionTaken>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
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        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiled>false</Form8038TFiled>
        <RebateNotDueYet>true</RebateNotDueYet>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
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      <Form990ScheduleKPartIV>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiled>false</Form8038TFiled>
        <RebateNotDueYet>true</RebateNotDueYet>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
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      <Form990ScheduleKPartIV>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiled>false</Form8038TFiled>
        <RebateNotDueYet>true</RebateNotDueYet>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
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      <Form990ScheduleKPartV>
        <BondReferenceCd>A</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>B</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>C</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>GEORGETOWN UNIVERSITY</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V</Relationship>
        <DescriptionOfTransaction>VARIOUS SERVICES</DescriptionOfTransaction>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>SURGICAL ADVISORY GROUP LLC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V</Relationship>
        <DescriptionOfTransaction>CONSULTING SERVICES</DescriptionOfTransaction>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Identifier>BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS</Identifier>
        <ReturnReference>SCHEDULE L, PART IV</ReturnReference>
        <Explanation>Dr. John DeGioia, a Board member of MedStar Health, is President and CEO of Georgetown University. Since June 2000, Georgetown University and MedStar Health, Inc. have maintained a clinical partnership agreement whereby MedStar Health owns and operates Georgetown University Hospital's clinical enterprise, and the parties purchase various services from one another pursuant to this affiliation. The net amount paid by MedStar Health and its affiliated businesses to Georgetown University for the year was $17.1M, including payments due under MedStar Health's asset purchase agreement with Georgetown University. Dr. John Kirkpatrick, a Board member of MedStar Health, owns more than 5% of The Surgical Advisory Group, LLC (SAG), which provides consulting services to MedStar Health. SAG's gross revenues received from MedStar Health for the year was $0.1M.</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>ORGANIZATION'S MISSION</Identifier>
        <ReturnReference>PART III, LINE 1</ReturnReference>
        <Explanation>MEDSTAR IS THE CONTROLLING ENTITY OF AN INTEGRATED HEALTH SERVICES ORGANIZATION (THE SYSTEM) OFFERING A WIDE VARIETY OF HEALTHCARE SERVICES TO RESIDENTS OF THE BALTIMORE-WASHINGTON, D.C. REGION (COMPRISING BALTIMORE CITY, ELEVEN COUNTIES IN MARYLAND, AND THE DISTRICT OF COLUMBIA). IT IS THE AREA'S LARGEST HEALTH SYSTEM AND ONE OF THE REGION'S LARGEST EMPLOYERS, WITH APPROXIMATELY 30,000 ASSOCIATES AND 6,000 AFFILIATED PHYSICIANS. THROUGH ITS HOSPITALS, OUTPATIENT FACILITIES, PHYSICIAN ORGANIZATIONS, AND OTHER HEALTH SERVICES AFFILIATES, THE SYSTEM OFFERS A BROAD CONTINUUM OF HEALTHCARE SERVICES INCLUDING ACUTE CARE (SECONDARY, TERTIARY AND QUATERNARY), PRIMARY CARE, EMERGENCY/URGENT CARE, REHABILITATION (HOSPITAL-BASED AND OUTPATIENT), POST ACUTE CARE, AMBULATORY SURGERY, HOME CARE, ADULT DAY CARE, HEALTH PROMOTION AND WELLNESS, AND MEDICAL RESEARCH AND EDUCATION. THE SYSTEM OPERATES THE LARGEST HOME HEALTH BUSINESS IN THE REGION WITH APPROXIMATELY 223,000 VISITS IN FISCAL 2013 AND MEDSTAR FAMILY CHOICE, A MEDICARE AND MEDICAID MANAGED CARE COMPANY, THAT COVERED OVER 44,100 LIVES AT JUNE 30, 2013. THE SYSTEM'S PHYSICIAN NETWORK INCLUDES APPROXIMATELY 1,300 FULL-TIME EQUIVALENT EMPLOYED PHYSICIANS. THE SYSTEM OFFERS SPECIALIZED SERVICES THAT INCLUDE CARDIAC SURGERY, NEUROLOGY, ORGAN TRANSPLANTATION, NEONATAL INTENSIVE CARE, CANCER CARE, SHOCK/TRAUMA, BURN CARE AND HAND SURGERY. MEDSTAR HEALTH RESEARCH INSTITUTE IS THE RESEARCH ARM FOR MEDSTAR, PROVIDING SCIENTIFIC, ADMINISTRATIVE, AND REGULATORY SUPPORT FOR RESEARCH PROGRAMS THAT COMPLEMENT THE KEY CLINICAL SERVICES AND TEACHING PROGRAMS IN ALL HOSPITALS IN THE SYSTEM. MEDSTAR HAS ONE OF THE LARGEST GRADUATE MEDICAL EDUCATION PROGRAMS IN THE COUNTRY, TRAINING APPROXIMATELY 1,100 MEDICAL RESIDENTS ANNUALLY, AND IS THE MEDICAL EDUCATION AND CLINICAL PARTNER OF GEORGETOWN UNIVERSITY. MEDSTAR ESTABLISHED AN INNOVATION ALLIANCE WITH THE CLEVELAND CLINIC TO BENEFIT PATIENTS THROUGH COLLABORATION ON RESEARCH, CLINICAL INVESTIGATION AND COMMERCIALIZATION. IN FISCAL YEAR 2013, MEDSTAR HEALTH'S HOSPITALS HAD 150,681 INPATIENT ADMISSIONS, 2,418,522 OUTPATIENT VISITS, AND 551,292 EMERGENCY VISITS. FAMILY/BUSINESS RELATIONSHIP PART VI, LINE 2 Kenneth Samet and Marc Duber, BOARD MEMBERS OF MEDSTAR HEALTH, both serve on the Board of an unrelated corporation. The unrelated corporation does not transact any business with MedStar Health.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROCESS FOR REVIEWING FORM 990</Identifier>
        <ReturnReference>PART VI, LINE 11B</ReturnReference>
        <Explanation>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, STRATEGIC PLANNING, 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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CONFLICT OF INTEREST</Identifier>
        <ReturnReference>PART VI, LINE 12C</ReturnReference>
        <Explanation>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) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH 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).</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>EXECUTIVE COMPENSATION PROCESS</Identifier>
        <ReturnReference>PART VI, LINE 15</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FINANCIAL STATEMENT AVAILABILITY</Identifier>
        <ReturnReference>PART VI, LINE 19</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS</Identifier>
        <ReturnReference>PART XI, LINE 9</ReturnReference>
        <Explanation>ADDITIONAL MINIMUM PENSION LIABILITY....................$ 38,926,264 EQUITY TRANSFERS - NET ASSETS...........................$ 94,963,063 TRNA - PLEDGE RECEIVABLE................................$ 838,714 =========== TOTAL $134,728,041</Explanation>
      </GeneralExplanation>
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          <State>MD</State>
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          <State>MD</State>
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          <City>Washington</City>
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          <City>Columbia</City>
          <State>MD</State>
          <ZIPCode>21044</ZIPCode>
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          <State>MD</State>
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          <State>MD</State>
          <ZIPCode>20705</ZIPCode>
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        <ControlledOrg>true</ControlledOrg>
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        <NameOfDisregardedEntity>
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        <AddressUS>
          <AddressLine1>4061 Powdermill Road</AddressLine1>
          <City>Calverton</City>
          <State>MD</State>
          <ZIPCode>20705</ZIPCode>
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        <ControlledOrg>true</ControlledOrg>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medstar VNA Healthcare</BusinessNameLine1>
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          <AddressLine1>4061 Powdermill Road Suite 210</AddressLine1>
          <City>Calverton</City>
          <State>MD</State>
          <ZIPCode>20705</ZIPCode>
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        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
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          <BusinessNameLine1>MGH Community Health Inc</BusinessNameLine1>
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          <AddressLine1>18101 Prince Philip Drive</AddressLine1>
          <City>Olney</City>
          <State>MD</State>
          <ZIPCode>20832</ZIPCode>
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        <EIN>521372467</EIN>
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</Return>