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        <NamePerson>MR JAMES T MOSES</NamePerson>
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          <State>VA</State>
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      <GrantsToDomesticOrgs>
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      <GrantsToDomesticIndividuals>
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      </GrantsToDomesticIndividuals>
      <ForeignGrants>
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      <BenefitsToMembers>
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      </FeesForServicesManagement>
      <FeesForServicesLegal>
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      <FeesForServicesAccounting>
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      <FeesForServicesLobbying>
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      <Travel>
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      <TravelEntrtnmntPublicOfficials>
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      <ConferencesMeetings>
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      <Interest>
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      <PaymentsToAffiliates>
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      <Insurance>
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        <ProgramServices>635239</ProgramServices>
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      <OtherExpenses>
        <Description>MAINTENANCE &amp; REPAIRS</Description>
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      <OtherExpenses>
        <Description>ALL OTHER EXPENSES</Description>
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        <Description>PENSION OBLIGATION</Description>
        <Amount>4305294</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>4305294</TotalOfAmounts>
      <TotRevenueEtcAuditedFinclStmt>14404790</TotRevenueEtcAuditedFinclStmt>
      <NetUnrealizedGainsInvestments>58374</NetUnrealizedGainsInvestments>
      <RevenueNotRptdF990>58374</RevenueNotRptdF990>
      <RevenueSubtotal>14346416</RevenueSubtotal>
      <InvestmentExpensesNotIncluded>665252</InvestmentExpensesNotIncluded>
      <RevenueNotRptdOnFinStmt>665252</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>15011668</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>16310780</TotExpensesEtcAuditedFinclStmt>
      <ExpensesSubtotal>16310780</ExpensesSubtotal>
      <InvestmentExpensesNotIncluded2>665252</InvestmentExpensesNotIncluded2>
      <ExpensesNotRptdOnFinStmt>665252</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>16976032</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIII>
        <Identifier>INTENDED USES OF ENDOWMENT FUNDS</Identifier>
        <ReturnReference>PART V, LINE 4</ReturnReference>
        <Explanation>the purposes of the endowments are for purchasing hospital beds and providing funds for resident emergencies.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationCommittee>X</CompensationCommittee>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>Robert A Crouse</NamePerson>
        <Title>Administrator</Title>
        <BaseCompensationFilingOrg>192941</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>33929</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>12081</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>238951</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>James T Moses</NamePerson>
        <Title>Controller/CFO</Title>
        <BaseCompensationFilingOrg>123032</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>21358</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>8658</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>153048</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>James Abbott MD</NamePerson>
        <Title>Medical Director</Title>
        <BaseCompensationFilingOrg>177764</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>31453</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>12793</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>222010</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>DOCUMENTATION OF COMMITTEE MEETINGS</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 8B</ReturnReference>
        <Explanation>Formal minutes are kept for the deliberation of two committees: Finance and Investment. All other committee activity is documented on a more informal basis through the notes of committee chairs. Periodically (usually at monthly meetings), each committee chair reports to the Board on the activities of their committee. Also, committees report on activities on an annual basis. The reporting is documented in Board minutes. PROCESS USED BY MANAGEMENT &amp;/OR GOVERNING BODY TO REVIEW FORM 990 FORM 990, PART VI, QUESTION 11B THE FORM 990 IS REVIEWED BY THE CONTROLLER/CFO PRIOR TO FILING.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 12C</ReturnReference>
        <Explanation>BOARD MEMBERS AND OFFICERS ARE REQUIRED TO SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY. IF A BOARD MEMBER HAS A CONFLICT, THEY ABSTAIN FROM VOTING ON THE ISSUE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OFFICES &amp; POSITIONS FOR WHICH PROCESS WAS USED, &amp; YEAR PROCESS WAS BEGIN</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTIONS 15A AND 15B</ReturnReference>
        <Explanation>MR. CROUSE'S COMPENSATION IS SET BY THE FINANCE COMMITTEE ANNUALLY. THE APPROVAL OF HIS COMPENSATION IS DOCUMENTED IN THE COMMITTEE MINUTES. OVERALL COMPENSATION LEVELS FOR ALL OTHER EMPLOYEES ARE DETERMINED BY THE ADMINISTRATOR AND/OR DEPARTMENTAL DIRECTORS UNDER A PERCENTAGE GUIDELINE DETERMINED BY THE FINANCE COMMITTEE. IN THE CASE OF THE CONTROLLER, COMPENSATION IS SET BY MR. CROUSE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, &amp; FIN STMTS TO GEN PUBLIC</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 19</ReturnReference>
        <Explanation>GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FORM 990 AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ALSO, FINANCIAL INFORMATION IS AVAILABLE ON-LINE THROUGH GUIDESTAR.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS OR FUND BALANCE</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 9</ReturnReference>
        <Explanation>CHANGE IN PENSION OBLIGATION $ -957,664 DECREASE IN VALUE OF BENEFICIAL INT IN TRUSTS $ 230,163 FLOW-THROUGH UBI LOSS FROM PARTNERSHIP $ 115,987 UNREALIZED GAIN ON ALTERNATIVE INVESTMENTS $ 4,100,096 ------------ OTHER CHANGES IN NET ASSETS $ 3,488,582 ============</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>