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        <InvestmentEarningsOrLosses>243</InvestmentEarningsOrLosses>
        <EndOfYearBalance>414414</EndOfYearBalance>
      </CurrentYearMinus4Years>
      <PermanentEndowmentEOYBalance>0.84944</PermanentEndowmentEOYBalance>
      <TermEndowmentEOYBalance>0.15057</TermEndowmentEOYBalance>
      <EndowmentsHeldByUnrelatedOrgs>false</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>true</EndowmentsHeldByRelatedOrgs>
      <AreRelatedOrgsListedScheduleR>true</AreRelatedOrgsListedScheduleR>
      <Land />
      <Buildings />
      <LeaseholdImprovements />
      <Equipment />
      <OtherLandBuildings />
      <OtherAssets>
        <Description>INTEREST IN ASSETS OF FND</Description>
        <BookValue>8401035</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>INVESTMENT IN UNCONSOL SUB</Description>
        <BookValue>2476871</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>DUE FROM AFFILIATES</Description>
        <BookValue>453575</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>DEFERRED FINANCING COSTS</Description>
        <BookValue>42181</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>11373662</TotalBookValueOtherAssets>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>DUE TO AFFILIATES</Description>
        <Amount>53500312</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>OTHER LIABILITIES</Description>
        <Amount>2919074</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>56419386</TotalOfAmounts>
      <TotRevenueEtcAuditedFinclStmt>79156885</TotRevenueEtcAuditedFinclStmt>
      <OtherRevenues>-3460109</OtherRevenues>
      <RevenueNotRptdF990>-3460109</RevenueNotRptdF990>
      <RevenueSubtotal>82616994</RevenueSubtotal>
      <TotalRevenuePerForm990>82616994</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>79434064</TotExpensesEtcAuditedFinclStmt>
      <OtherExpensesIncluded>-372927</OtherExpensesIncluded>
      <ExpensesNotRptdF990>-372927</ExpensesNotRptdF990>
      <ExpensesSubtotal>79806991</ExpensesSubtotal>
      <TotalExpensesPerForm990>79806991</TotalExpensesPerForm990>
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        <Identifier>RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990</Identifier>
        <ReturnReference>SCHEDULE D, PART XI, LINE 2D</ReturnReference>
        <Explanation>EQUITY IN EARNINGS OF AFFILIATE - FOUNDATION $ (3,460,109)</Explanation>
      </Form990ScheduleDPartXIII>
      <Form990ScheduleDPartXIII>
        <Identifier>INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS</Identifier>
        <ReturnReference>SCHEDULE D, PART V, LINE 4</ReturnReference>
        <Explanation>THE ORGANIZATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR THE ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND ITEMS SUPPORTED BY THE ENDOWMENT WHILE SEEKING TO MAINTAIN ITS PURCHASING POWER.</Explanation>
      </Form990ScheduleDPartXIII>
      <Form990ScheduleDPartXIII>
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        <ReturnReference>SCHEDULE D, PART XII, LINE 2D</ReturnReference>
        <Explanation>EQUITY EARNINGS INCLUDED WITH EXPENSE ON AUDIT $ (372,927)</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="IRS990ScheduleI">
      <RecordsMaintained>true</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>CATHOLIC DIOCESE OF TYLER</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1015 SE LOOP 323</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EINOfRecipient>756002676</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>25000</AmountOfCashGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>CANCER FOUNDATION FOR LIFE</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO BOX 8257</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75711</ZIPCode>
        </AddressUS>
        <EINOfRecipient>752957440</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>25000</AmountOfCashGrant>
        <PurposeOfGrant>COMMUNITY HEALTHCARE DONATION</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>AMERICAN HEART ASSOCIATION</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO BOX 4002903</AddressLine1>
          <City>DES MOINES</City>
          <State>IA</State>
          <ZIPCode>50340</ZIPCode>
        </AddressUS>
        <EINOfRecipient>135613797</EINOfRecipient>
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      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>AMERICAN CANCER SOCIETY</BusinessNameLine1>
        </RecipientNameBusiness>
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          <AddressLine1>1301 S BROADWAY</AddressLine1>
          <City>TYLER</City>
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        <EINOfRecipient>131788491</EINOfRecipient>
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        <PurposeOfGrant>2011 CATTLE BARONS</PurposeOfGrant>
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      <RecipientTable>
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        </RecipientNameBusiness>
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      <RecipientTable>
        <RecipientNameBusiness>
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        <PurposeOfGrant>COMMUNITY HEALTHCARE SPONSORSHIP</PurposeOfGrant>
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      <RecipientTable>
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      <RecipientTable>
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        <NamePerson>THOMAS WILKEN</NamePerson>
        <Title>SR VP</Title>
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        <NamePerson>ANDREW VON ESCHENBACH</NamePerson>
        <Title>ADMIN DIRECTOR</Title>
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      <Form990ScheduleJPartII>
        <NamePerson>MARY E DODD</NamePerson>
        <Title>PROJECT DIRECTOR</Title>
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        <NamePerson>BOBBIE OGG</NamePerson>
        <Title>PROJECT MANAGER</Title>
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      <Form990ScheduleJPartII>
        <NamePerson>MARY JACKSON</NamePerson>
        <Title>VP</Title>
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      <Form990ScheduleJPartII>
        <NamePerson>ANDY NAVARRO</NamePerson>
        <Title>VP LEGAL COUNSEL</Title>
        <BaseCompensationFilingOrg>312339</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>50296</BonusFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>DAVID TEEGARDEN MD</NamePerson>
        <Title>SYSTEM PRESIDENT/CMO/DIRECTOR</Title>
        <BaseCompensationFilingOrg>197563</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
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      <Form990ScheduleJPartIII>
        <Identifier>PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 4B</ReturnReference>
        <Explanation>PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- --------------- --------------------- LINDSEY BRADLEY NONE NONE RAY THOMPSON $528,232 NONE STEVEN KEUER MD $394,866 NONE DAVID TEEGARDEN MD NONE NONE PARTICIPANTS IN 457(F) REPORTED IN W-2 ---------------------- ----------------- STEVEN KEUER MD $537 DAVID TEEGARDEN MD NONE ROGER FOWLER MD NONE</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>SEVERANCE PAYMENTS</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 4A</ReturnReference>
        <Explanation>SEVERANCE PAID -------------- JEFFREY HYDE $168,688</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>TAX INDEMNIFICATION &amp; GROSS UP PAYMENTS</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 1A</ReturnReference>
        <Explanation>Amounts paid for "grossed up" gift cards are included as taxable compensation for the following directors: ROGER FOWLER, LEE PORTWOOD, ELIZABETH PULLIAM, JEFFREY PEARSON, DARIN SZILAGYI, THOMAS WILKEN, ANDY NAVARRO, DAVID NORTHCUTT, ANDREW VON ESCHENBACH, MARY DODD, BOBBIE OGG, CAROL LECLAIR, JOHN WEBB, AND MARY JACKSON</Explanation>
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    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>DESCRIBE REVIEW PROCESS OF FORM 990</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 11B</ReturnReference>
        <Explanation>THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS AND A COPY IS PROVIDED TO THE BOARD PRIOR TO FILING.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIBE THE ORGANIZATION'S MEMBERS OR STOCKHOLDERS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 6</ReturnReference>
        <Explanation>THE SOLE MEMBER IS THE CONGREGATION OF THE SISTERS OF THE HOLY FAMILY OF NAZARETH, A RELIGIOUS ORDER OF THE ROMAN CATHOLIC CHURCH.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BOARD</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 7A</ReturnReference>
        <Explanation>THE MEMBER HAS THE SOLE RIGHT AND AUTHORITY TO APPOINT ONE OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DECISIONS OF THE GOVERNING BOARD SUBJECT TO APPROVAL OF MEMBERS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 7B</ReturnReference>
        <Explanation>THE MEMBER HAS THE RIGHT TO APPROVE OR DISAPPROVE CERTAIN ACTIONS THAT HAVE BEEN PREVIOUSLY APPROVED BY THE BOARD OF DIRECTORS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOW DOES THE ORGANIZATION MONITOR AND ENFORCE COMPLIANCE WITH POLICY</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>THE BOARD REVIEWS AND RESOLVES, IF NECESSARY, ANY TRANSACTIONS AS THEY ARISE THROUGHOUT THE YEAR IN ACCORDANCE WITH POLICY STANDARDS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROCESS FOR DETERMINING COMPENSATION OF CEO, OFFICERS, OR KEY EMPLOYEES</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINES 15A &amp; 15B</ReturnReference>
        <Explanation>THE ORGANIZATION USES COMPENSATION CONSULTANTS AND NATIONAL COMPENSATION SURVEYS TO DETERMINE COMPENSATION OF EMPLOYEES. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIBE WHETHER THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE TO PUBLIC</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION FROM RELATED ORGANIZATIONS</Identifier>
        <ReturnReference>FORM 990, PART VII &amp; SCHEDULE J</ReturnReference>
        <Explanation>THE GOVERNING BOARD OF TRINITY MOTHER FRANCES HEALTH SYSTEM UPON ADVICE FROM NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS, WHO PERIODICALLY REVIEW ALL EXECUTIVE COMPENSATION, APPROVED A DEFERRED COMPENSATION PLAN THAT PROVIDES A 65% TOTAL RETIREMENT BENEFIT FOR SENIOR EXECUTIVES THAT SERVE 20 YEARS OR MORE. THIS PROGRAM HAS BOTH RETENTION AND NON-COMPETITION CLAUSES THAT CREATE A RISK OF FORFEITURE. DEFERRED COMPENSATION IS SUBJECT TO A RISK OF FORFEITURE BASED ON RETENTION, NON-COMPETITION AND OTHER CONTRACTUAL FACTORS. ACCRUALS OF DEFERRED COMPENSATION ARE NOT INCLUDIBLE IN W-2 COMPENSATION UNTIL PAID. OTHER EMPLOYEE BENEFITS INCLUDE QUALIFIED PENSION PLANS, HEALTH, DENTAL AND LIFE INSURANCE PLANS, DISABILITY INSURANCE, ETC. TAXABLE EXPENSES ARE INCLUDED IN THE W-2 PAID COMPENSATION SALARY AMOUNT.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>1099S REPORTED BY ORGANIZATION</Identifier>
        <ReturnReference>FORM 990, PART V, LINE 1A</ReturnReference>
        <Explanation>THE ORGANIZATION'S 1099S ARE ISSUED BY A RELATED ORGANIZATION, MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, WHO REPORTS ALL 1099S FOR THE ENTIRE SYSTEM AND ALLOCATES EXPENSES TO THE APPROPRIATE RELATED ORGANIZATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 9</ReturnReference>
        <Explanation>OTHER CHANGES IN NET ASSETS: TRANSFERS FROM AFFILIATES $ 42,877,547 CHANGE IN FINANCIAL INTEREST - TEMP RESTRICTED (3,613,720) CHANGE IN FINANCIAL INTEREST - PERM RESTRICTED (50,621) EQUITY IN EARNINGS OF AFFILIATE - FOUNDATION (3,460,109) EQUITY EARNINGS INCLUDED WITH EXPENSE ON AUDIT 372,927 --------------- $ 36,126,024</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES</Identifier>
        <ReturnReference>FORM 990, PART IX, LINE 11G</ReturnReference>
        <Explanation>CONTRACT LABOR $ 3,052,851 PURCHASED SERVICES 7,074,200 CONSULTING 1,735,499 PROFESSIONAL FEES 204,411 COLLECTION FEES 2,418,158 BOND FUND EXPENSE 8,000 SPORTSCARE 7,146 PROMOTIONS/SPONSORSHIP 159,737 ------------- $ 14,660,002</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL REGIONAL HC CTR</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>750818167</EIN>
        <PrimaryActivities>HOSPITAL</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>TMFHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL - JACKSONVILLE</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>751976930</EIN>
        <PrimaryActivities>HOSPITAL</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
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          <BusinessNameLine1>TMFHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>TRINITY MOTHER FRANCES HEALTH SYSTEM FDN</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
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        <EIN>752028241</EIN>
        <PrimaryActivities>SUPPORT</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11, TYPE I</PublicCharityStatus>
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          <BusinessNameLine1>TMFHS</BusinessNameLine1>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>REGIONAL MEDICAL SERVICES ASSOCIATION</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
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        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
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          <BusinessNameLine1>MFH REG</BusinessNameLine1>
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          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
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          <BusinessNameLine1>MOTHER FRANCES HOSPITAL - WINNSBORO</BusinessNameLine1>
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          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
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        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
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          <BusinessNameLine1>tri-state financial llc</BusinessNameLine1>
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          <City>tyler</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752728318</EIN>
        <PrimaryActivity>COLLECTION AGENCY</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
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        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
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      <Form990ScheduleRPartIV>
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          <BusinessNameLine1>TRINCARE INC</BusinessNameLine1>
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          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752161369</EIN>
        <PrimaryActivity>RETAIL HEALTH SVC</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
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        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
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      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>HEALTHPLAN OF TEXAS INC</BusinessNameLine1>
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          <AddressLine1>1315 doctors drive</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752636832</EIN>
        <PrimaryActivity>THIRD PARTY ADMIN</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>TMFHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
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        <ShareOfEOYAssets>101283</ShareOfEOYAssets>
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      <Form990ScheduleRPartIV>
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          <BusinessNameLine1>THE REGIONAL HEALTHCARE ALLIANCE</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752484109</EIN>
        <PrimaryActivity>PREFER PROVIDER</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>TMFHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>-5766</ShareOfTotalIncome>
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        <PercentageOwnership>1.00000</PercentageOwnership>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>TEXAS HEALTH FACILITIES INSUR CORP LTD</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressForeign>
          <AddressLine1>PO BOX 1109 BWI</AddressLine1>
          <ProvinceOrState>GRAND CAYMAN</ProvinceOrState>
          <Country>CJ</Country>
        </AddressForeign>
        <EIN>980136025</EIN>
        <PrimaryActivity>INSURANCE</PrimaryActivity>
        <LegalDomicileForeignCountry>CJ</LegalDomicileForeignCountry>
        <DirectControllingEntityName>
          <BusinessNameLine1>MFH REG</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>CONCORDIUM HEALTH LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>702811022</EIN>
        <PrimaryActivity>INACTIVE</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>true</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>false</DividendsRelatedOrganization>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>true</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>true</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>54701085</AmountInvolved>
        <MethodOfAmtDetermination>FAIR VALUE</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>TRINITY CLINIC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>14412250</AmountInvolved>
        <MethodOfAmtDetermination>FAIR VALUE</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL - JACKSONVILLE</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>3448988</AmountInvolved>
        <MethodOfAmtDetermination>FAIR VALUE</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL - WINNSBORO</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>1709322</AmountInvolved>
        <MethodOfAmtDetermination>FAIR VALUE</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>TRINCARE INC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>633000</AmountInvolved>
        <MethodOfAmtDetermination>FAIR VALUE</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>TRINITY MOTHER FRANCES HEALTH SYSTEM FDN</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>C</TransactionType>
        <AmountInvolved>102800</AmountInvolved>
        <MethodOfAmtDetermination>FAIR VALUE</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <Form990ScheduleRPartVII>
        <Identifier>DIRECT CONTROLLING ENTITY</Identifier>
        <ReturnReference>SCHEDULE R, PART II, COLUMN F</ReturnReference>
        <Explanation>THE FOLLOWING RELATED ORGANIZATIONS REPORTABLE IN PART II ARE DIRECTLY CONTROLLED BY TRINITY MOTHER FRANCES HEALTH SYSTEM ("TMFHS"): MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER MOTHER FRANCES HOSPITAL - JACKSONVILLE TRINITY MOTHER FRANCES HEALTH SYSTEM FOUNDATION TRINITY CLINIC MOTHER FRANCES HOSPITAL - WINNSBORO REGIONAL MEDICAL SERVICES ASSOCIATION IS DIRECTLY CONTROLLED BY MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER ("MFH REG").</Explanation>
      </Form990ScheduleRPartVII>
    </IRS990ScheduleR>
  </ReturnData>
</Return>