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        <Identifier>FIN 48 FOOTNOTE</Identifier>
        <ReturnReference>SCHEDULE D, PART X</ReturnReference>
        <Explanation>INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2013.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent400>X</Pcent400>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>13773851</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>13773851</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01300</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>152456788</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>138484644</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>13972144</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01300</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>6142020</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>2542804</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>3599216</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00300</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>172372659</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>141027448</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>31345211</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02900</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>2275661</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>2275661</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00200</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>64921343</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>21600572</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>43320771</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.04100</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>31058107</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>23311926</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>7746181</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00700</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <Research>
        <TotalCommunityBenefitExpense>907874</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>907874</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00100</PercentOfTotalExpense>
      </Research>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>65967</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>65967</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>99228952</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>44912498</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>54316454</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05110</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>271601611</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>185939946</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>85661665</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.08010</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <PhysicalImprovementsAndHousing>
        <TotalCommunityBuildingExpense>8565</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>8565</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </PhysicalImprovementsAndHousing>
      <CommunitySupport>
        <TotalCommunityBuildingExpense>51092</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>51092</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </CommunitySupport>
      <HealthImprovementAdvocacy>
        <TotalCommunityBuildingExpense>45140</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>45140</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00040</PercentOfTotalExpense>
      </HealthImprovementAdvocacy>
      <Total>
        <TotalCommunityBuildingExpense>104797</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>104797</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00060</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>83583292</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>319569830</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>317421381</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>2148449</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>WASHINGTON HOSPITAL CENTER</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>110 IRVING STREET NW</AddressLine1>
          <City>WASHINGTON</City>
          <State>DC</State>
          <ZIPCode>20010</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <TeachingHospital>X</TeachingHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>WASHINGTON HOSPITAL CENTER</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <NeedsAssessmentConducted>11</NeedsAssessmentConducted>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>false</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OwnWebsite>X</OwnWebsite>
        <OnRequest>X</OnRequest>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>false</AllNeedsAddressed>
        <OrganizationIncurExciseTax>false</OrganizationIncurExciseTax>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>400.</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <AssetLevel>X</AssetLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <InsuranceStatus>X</InsuranceStatus>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AverageNegotiatedRates>X</AverageNegotiatedRates>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Identifier>CHARITY CARE AND CERTAIN OTHER BENEFITS AT COST</Identifier>
        <ReturnReference>PART I, LINE 7</ReturnReference>
        <Explanation>MEDICARE COST REPORT DATA AS WELL AS COST-TO-CHARGE RATIO WERE USED TO CALCULATE FIGURES REPORTED (WHERE APPLICABLE). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST-TO-CHARGES. PERCENT OF TOTAL EXPENSE PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE OF $83,583,292 HAS BEEN REMOVED FROM TOTAL EXPENSE TO CALCULATE THE PERCENTAGES IN COLUMN (F). BAD DEBT PART III, LINE 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8 MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>MEDICARE</Identifier>
        <ReturnReference>PART III, LINE 8</ReturnReference>
        <Explanation>THE AMOUNT REPORTED ON PART III, LINE 6 WAS DETERMINED USING THE COST DATA FROM THE FY 2012 MEDICARE COST REPORT. DEBT COLLECTION POLICY PART III, LINE 9 IF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>NEEDS ASSESSMENT</Identifier>
        <ReturnReference>PART V, SECTION B, LINE 7</ReturnReference>
        <Explanation>The implementation strategies serve as a roadmap for how community benefit resources will be allocated and deployed. MedStar's hospitals will be able to measure our contribution to improving the health of underserved and vulnerable populations in the regions we serve. Three-year implementation strategies with measurable objectives were developed for each hospital's community benefit service area - a specific community or target population of focus. Priorities were based on community need as determined by quantitative data and community input, as well as on hospital expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. The MedStar Health Corporate Community Health Department will provide system-wide coordination and oversight of community benefit programming. PART VI, LINE 2 IN FY12, MEDSTAR WASHINGTON HOSPITAL CENTER (THE HOSPITAL CENTER) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ACCORDANCE WITH THE GUIDELINES ESTABLISHED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE INTERNAL REVENUE SERVICE. THE HOSPITAL'S CHNA WAS LED BY 24 ADVISORY TASK FORCE (ATF) MEMBERS, WHICH WAS COMPRISED OF A DIVERSE GROUP OF INDIVIDUALS, INCLUDING COMMUNITY RESIDENTS, FAITH-BASED LEADERS, HOSPITAL REPRESENTATIVES AND PUBLIC HEALTH EXPERTS. THE ATF REVIEWED QUANTITATIVE AND QUALITATIVE COMMUNITY HEALTH DATA, AS WELL AS LOCAL, REGIONAL AND NATIONAL HEALTH GOALS. BASED ON THEIR FINDINGS, THE ATF DESIGNED A SURVEY TO IDENTIFY TRENDS IN HOW PARTICIPANTS PERCEIVED THE SEVERITY OF KEY HEALTH ISSUES IN THE FOLLOWING CATEGORIES: WELLNESS AND PREVENTION, ACCESS TO CARE, QUALITY OF LIFE, AND ENVIRONMENT. COMMUNITY MEMBERS RESPONDED TO THE SURVEY BY ATTENDING A COMMUNITY INPUT SESSION OR COMPLETING IT ONLINE OR VIA HARDCOPY. BASED ON THE ATF'S RECOMMENDATION, THE HOSPITAL IDENTIFIED DISTRICT OF COLUMBIA WARD 5 AS ITS COMMUNITY BENEFIT SERVICE AREA (CBSA) - A GEOGRAPHY WITH A HIGH DENSITY OF LOW-INCOME OR VULNERABLE RESIDENTS WITHIN CLOSE PROXIMITY OF THE HOSPITAL. HEALTH PRIORITIES FOR THE CBSA INCLUDE HEART DISEASE, DIABETES, AND OBESITY. THE HOSPITAL'S FY12 CHNA AND 3-YEAR IMPLEMENTATION STRATEGY WAS ENDORSED BY THE HOSPITAL CENTER'S BOARD OF DIRECTORS AND APPROVED BY THE MEDSTAR HEALTH BOARD OF DIRECTORS. THE DOCUMENT BECAME AVAILABLE ON THE HOSPITAL'S OFFICIAL WEBSITE ON JUNE 30, 2012. AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM THE HOSPITAL CENTER ROUTINELY PARTICIPATE IN THE MEDSTAR HEALTH COMMUNITY BENEFIT WORKGROUP. THE WORKGROUP IS COMPRISED OF COMMUNITY HEALTH PROFESSIONALS WHO REPRESENT ALL NINE MEDSTAR HOSPITALS. THE TEAM ANALYZES LOCAL AND REGIONAL COMMUNITY HEALTH DATA, ESTABLISHES SYSTEM-WIDE COMMUNITY HEALTH PROGRAMMING PERFORMANCE AND EVALUATION MEASURES AND SHARES BEST PRACTICES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</Identifier>
        <ReturnReference>PART VI, LINE 3</ReturnReference>
        <Explanation>AS ONE OF THE REGION'S LEADING NOT-FOR-PROFIT HEALTHCARE SYSTEMS, MEDSTAR HEALTH IS COMMITTED TO ENSURING THAT UNINSURED PATIENTS WITHIN THE COMMUNITIES WE SERVE WHO LACK FINANCIAL RESOURCES HAVE ACCESS TO NECESSARY HOSPITAL SERVICES. MEDSTAR HEALTH AND ITS HEALTHCARE FACILITIES WILL: " TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, WITH RESPECT AND WITH COMPASSION. " SERVE THE EMERGENCY HEALTH CARE NEEDS OF EVERYONE WHO PRESENTS AT OUR FACILITIES REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR CARE. " ASSIST THOSE PATIENTS WHO ARE ADMITTED THROUGH OUR ADMISSIONS PROCESS FOR NON-URGENT, MEDICALLY NECESSARY CARE WHO CANNOT PAY FOR PART OF ALL OF THE CARE THEY RECEIVE. " BALANCE NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO KEEP ITS HOSPITALS' DOORS OPEN FOR ALL WHO MAY NEED CARE IN THE COMMUNITY. IN MEETING ITS COMMITMENTS, MEDSTAR HEALTH'S FACILITIES WILL WORK WITH THEIR UNINSURED PATIENTS TO GAIN AN UNDERSTANDING OF EACH PATIENT'S FINANCIAL RESOURCES PRIOR TO ADMISSION (FOR SCHEDULED SERVICES) OR PRIOR TO BILLING (FOR EMERGENCY SERVICES). BASED ON THIS INFORMATION AND PATIENT ELIGIBILITY, MEDSTAR HEALTH'S FACILITIES WILL ASSIST UNINSURED PATIENTS WHO RESIDE WITHIN THE COMMUNITIES WE SERVE IN ONE OR MORE OF THE FOLLOWING WAYS: " ASSIST WITH ENROLLMENT IN PUBLICLY-FUNDED ENTITLEMENT PROGRAMS (E.G., MEDICAID). " ASSIST WITH ENROLLMENT IN PUBLICLY-FUNDED PROGRAMS FOR THE UNINSURED (E.G., D.C. HEALTHCARE ALLIANCE). " ASSIST WITH CONSIDERATION OF FUNDING THAT MAY BE AVAILABLE FROM OTHER CHARITABLE ORGANIZATIONS. " PROVIDE CHARITY CARE AND FINANCIAL ASSISTANCE ACCORDING TO APPLICABLE GUIDELINES. " PROVIDE FINANCIAL ASSISTANCE FOR PAYMENT OF FACILITY CHARGES USING A SLIDING SCALE BASED ON PATIENT FAMILY INCOME AND FINANCIAL RESOURCES. " OFFER PERIODIC PAYMENT PLANS TO ASSIST PATIENTS WITH FINANCING THEIR HEALTHCARE SERVICES. EACH MEDSTAR HEALTH FACILITY (IN COOPERATION AND CONSULTATION WITH THE FINANCE DIVISION OF MEDSTAR HEALTH) WILL SPECIFY THE COMMUNITIES IT SERVES BASED ON THE GEOGRAPHIC AREAS IT HAS SERVED HISTORICALLY FOR THE PURPOSE OF IMPLEMENTING THIS POLICY. EACH FACILITY WILL POST THE POLICY, INCLUDING A DESCRIPTION OF THE APPLICABLE COMMUNITIES IT SERVES, IN EACH MAJOR PATIENT REGISTRATION AREA AND IN ANY OTHER AREAS REQUIRED BY APPLICABLE REGULATIONS, WILL COMMUNICATE THE INFORMATION TO PATIENTS AS REQUIRED BY THIS POLICY AND APPLICABLE REGULATIONS AND WILL MAKE A COPY OF THE POLICY AVAILABLE TO ALL PATIENTS. MEDSTAR HEALTH BELIEVES THAT ITS PATIENTS HAVE PERSONAL RESPONSIBILITIES RELATED TO THE FINANCIAL ASPECTS OF THEIR HEALTHCARE NEEDS. THE CHARITY CARE, FINANCIAL ASSISTANCE, AND PERIODIC PAYMENT PLANS AVAILABLE UNDER THIS POLICY WILL NOT BE AVAILABLE TO THOSE PATIENTS WHO FAIL TO FULFILL THEIR RESPONSIBILITIES. FOR PURPOSES OF THIS POLICY, PATIENT RESPONSIBILITIES INCLUDE: " COMPLETING FINANCIAL DISCLOSURE FORMS NECESSARY TO EVALUATE THEIR ELIGIBILITY FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS, CHARITY CARE PROGRAMS, AND OTHER FORMS OF FINANCIAL ASSISTANCE. THESE DISCLOSURE FORMS MUST BE COMPLETED ACCURATELY, TRUTHFULLY, AND TIMELY TO ALLOW MEDSTAR HEALTH'S FACILITIES TO PROPERLY COUNSEL PATIENTS CONCERNING THE AVAILABILITY OF FINANCIAL ASSISTANCE. " WORKING WITH THE FACILITY'S FINANCIAL COUNSELORS AND OTHER FINANCIAL SERVICES STAFF TO ENSURE THERE IS A COMPLETE UNDERSTANDING OF THE PATIENT'S FINANCIAL SITUATION AND CONSTRAINTS. " COMPLETING APPROPRIATE APPLICATIONS FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS. THIS RESPONSIBILITY INCLUDES RESPONDING IN A TIMELY FASHION TO REQUESTS FOR DOCUMENTATION TO SUPPORT ELIGIBILITY. " MAKING APPLICABLE PAYMENTS FOR SERVICES IN A TIMELY FASHION, INCLUDING ANY PAYMENTS MADE PURSUANT TO DEFERRED AND PERIODIC PAYMENT SCHEDULES. " PROVIDING UPDATED FINANCIAL INFORMATION TO THE FACILITY'S FINANCIAL COUNSELORS ON A TIMELY BASIS AS THE PATIENT'S CIRCUMSTANCES MAY CHANGE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY INFORMATION</Identifier>
        <ReturnReference>PART VI, LINE 4</ReturnReference>
        <Explanation>THE HOSPITAL CENTER'S COMMUNITY BENEFIT ACTIVITIES FOCUS ON WARD 5 (ZIP CODES 20001, 20002, 20009, 20010, 20011), THOUGH SOME DO EXTEND THROUGHOUT THE METROPOLITAN AREA. WARD 5, WHICH IS LOCATED IN THE NORTHEASTERN QUADRANT OF THE DISTRICT OF COLUMBIA, WAS SELECTED AS THE PRIORITY AREA DUE TO ITS PROXIMITY TO THE HOSPITAL, COUPLED WITH AN OPPORTUNITY TO BUILD UPON PRE-EXISTING PROGRAMS AND SERVICES FOR THE COMMUNITY. WARD 5 IS LOCATED IN THE NORTHEASTERN QUADRANT OF THE DISTRICT OF COLUMBIA. IT IS THE HOME OF APPROXIMATELY 74,308 RESIDENTS; 83% ARE ADULTS AGE 18 AND OLDER. THE MAJORITY OF RESIDENTS ARE AFRICAN AMERICAN (77%). FIFTEEN PERCENT (15%) ARE WHITE AND 6.3% ARE HISPANIC. THE AVERAGE HOUSEHOLD INCOME IN WARD 5 ($75,559) IS LESS THAN THE CITY AVERAGE ($115,016). THE PERCENT OF ADULTS WITHOUT A HIGH SCHOOL DIPLOMA (19%) IS GREATER THAN THE CITY AVERAGE (15%) (NEIGHBORHOOD INFO DC). THE EDGEWOOD NEIGHBORHOOD IS A HISTORIC HILLTOP NEIGHBORHOOD THAT ENJOYS BOTH MODERN CONVENIENCES AND ITS LINKS TO THE PAST, INCLUDING DECO APARTMENTS, DC VERNACULAR ROW HOMES, A COMMERCIAL DISTRICT WITH LOCAL AND NATIONAL RETAILER'S SERVICES AND ALONG THE HISTORIC METROPOLITAN BRANCH RAIL LINE TODAY IS A METRO STATION AND A NEW BIKING AND WALKING TRAIL. THE BLOOMINGDALE NEIGHBORHOOD IS A SMALL RESIDENTIAL NEIGHBORHOOD IN THE NORTHWEST AREA OF THE DISTRICT WITH RESIDENTS, YOUNG PROFESSIONALS AND THEIR FAMILIES. BROOKLAND HAS DEVELOPED INTO A NEIGHBORHOOD FAIRLY INTEGRATED AMONG ECONOMIC CLASSES, RACES AND HAS A SMALL THRIVING BUSINESS COMMUNITY, INCLUDING PROMINENT COMMUNITY DIVERSITY. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 AS A COMMUNITY PARTNER, MEDSTAR WASHINGTON HOSPITAL CENTER ENGAGES IN A NUMBER OF COMMUNITY BENEFIT ACTITIVES TO PROMOT THE HEALTH AND WELLBEING OF THE COMMUNITY. EXAMPLES INCLUDE, BUT ARE NOT LIMITED TO: CANCER SUPPORT GROUPS, AEROBICS CLASSES, WALKING PROGRAMS, AND ROUTINE BLOOD PRESSURE AND DIABETES SCREENING SERVICES. THE HOSPITAL CENTER'S MEDICAL HOUSE CALL PROGRAM PROVIDES PRIMARY CARE AND SUPPORT SERVICES TO A GROWING AGING POPULATION AND THE TEEN ALLIANCE FOR PREPARED PARENTING'S MISSION IS TO PREVENT SUBSEQUENT CASES OF TEEN PREGNANCY. THROUGH ITS PARTNERSHIP WITH THE AMERICAN ASSOCIATION OF RETIRED PERSONS, CLASSES ARE OFFERED TO PROMOTE SAFE DRIVING HABITS AMONG SENIOR CITIZENS. IN PARTNERSHIP WITH THE WASHINGTON NATIONAL EYE CARE CENTER, THE HOSPITAL CENTER SERVES AS THE REGION'S LEADING EYE CARE REFERRAL CENTER FOR PERSONS WHO ARE UNINSURED.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>AFFILIATED HEALTH CARE SYSTEM</Identifier>
        <ReturnReference>PART VI, LINE 6</ReturnReference>
        <Explanation>AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR WASHINGTON HOSPITAL CENTER IS ABLE TO EXPAND ITS CAPACITY TO MEET THE NEEDS OF THE COMMUNITY BY PARTNERING WITH OTHER MEDSTAR HOSPITALS AND ASSOCIATED ENTITIES. MEDSTAR HEALTH RESOURCES ASSIST THE HOSPITAL IN COMMUNITY HEALTH PLANNING TO MEET THE NEEDS OF THE UNINSURED AND OTHER VULNERABLE POPULATIONS. THROUGH ITS COMMUNITY HEALTH FUNCTION, MEDSTAR HEALTH PROVIDES THE HOSPITAL CENTER WITH TECHNICAL SUPPORT TO ENHANCE COMMUNITY HEALTH PROGRAMMING AND EVALUATION. MEDSTAR'S CORPORATE PHILANTHROPY DIVISION IDENTIFIES PUBLIC AND PRIVATE FUNDING SOURCES TO ENSURE THE AVAILABILITY OF HIGH QUALITY HEALTH SERVICES, REGARDLESS OF ABILITY TO PAY.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>State filing of community benefit report</Identifier>
        <ReturnReference>PART VI, LINE 7</ReturnReference>
        <Explanation>THE COMMUNITY BENEFIT REPORT FOR MEDSTAR WASHINGTON HOSPITAL CENTER IS ONLY FILED IN THE DISTRICT OF COLUMBIA.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <IdemnificationGrossUpPayments>X</IdemnificationGrossUpPayments>
      <HousingAllowanceOrResidence>X</HousingAllowanceOrResidence>
      <WrittenPolicyReTAndEExpenses>true</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>true</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
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        <NamePerson>STEVEN BOYCE</NamePerson>
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        <Identifier>TEMPORARY HOUSING ALLOWANCE AND GROSS-UP PAYMENTS</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 1A</ReturnReference>
        <Explanation>TWO OFFICERS OF THE ORGANIZATION, JOHN SULLIVAN AND DOUGLAS ZEHNER, RECEIVED REIMBURSEMENT PAYMENTS RELATED TO TEMPORARY HOUSING EXPENSES INCURRED WHILE RELOCATING TO THEIR NEW POSITIONS WITH THE ORGANIZATION. THE REIMBURSEMENT PAYMENTS WERE GROSSED-UP FOR INCOME TAX PURPOSES. THE TOTAL AMOUNT OF THE PAYMENTS RECEIVED WERE TREATED AS TAXABLE COMPENSATION.</Explanation>
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        <ReturnReference>SCHEDULE J, PART , LINES 4A AND 4B</ReturnReference>
        <Explanation>KENNETH SAMET MR. SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $928,678 REPRESENTING HIS BENEFIT FROM A SUPPLEMENTAL RETIREMENT PLAN, WHICH WAS EARNED DURING THE PAST 24 YEARS OF SERVICE. A PORTION OF THIS AMOUNTS, $208,524, WAS ALSO REPORTED ON FORM 990 IN PRIOR YEARS. JOHN SULLIVAN An officer of the organization, John Sullivan, received a reimbursement payment related to temporary housing expenses incurred while relocating to his new position with the organization. The reimbursement payment was grossed-up for income tax purposes. The total amount of the payment received was treated as taxable compensation. Harrison Rider Harrison Rider's Other reportable compensation in Part II, Column (B) (iii) includes $128,640 representing the amount of supplemental retirement benefit payments relating to prior years of service. In addition, Part II, Column (B) (iii) includes $923,613 relating to income realized in the current year on the appreciation of certain investments that were granted to Mr. Rider in prior years and which related to services performed in prior years. DOUGLAS ZEHNER AN OFFICER OF THE ORGANIZATION, DOUGLAS ZEHNER, RECEIVED A REIMBURSEMENT PAYMENT RELATED TO TEMPORARY HOUSING EXPENSES INCURRED WHILE RELOCATING TO HIS NEW POSITION WITH THE ORGANIZATION. THE REIMBURSEMENT PAYMENT WAS GROSSED-UP FOR INCOME TAX PURPOSES. THE TOTAL AMOUNT OF THE PAYMENT RECEIVED WAS TREATED AS TAXABLE COMPENSATION.</Explanation>
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      <GeneralExplanation>
        <Identifier>EXEMPT PURPOSE ACHIEVEMENTS</Identifier>
        <ReturnReference>PART III, LINE 4A</ReturnReference>
        <Explanation>MEDSTAR HEART INSTITUTE, HEADQUARTERED AT MWHC, IS A NATIONAL LEADER IN THE RESEARCH, DIAGNOSIS AND TREATMENT OF CARDIOVASCULAR DISEASE AND RECENTLY ENTERED INTO A CLINICAL AND RESEARCH ALLIANCE WITH THE SYDELL AND ARNOLD MILLER FAMILY HEART &amp; VASCULAR INSTITUTE AT CLEVELAND CLINIC. MWHC'S ORGAN TRANSPLANTATION CAPABILITIES INCLUDE HEART, PANCREAS AND KIDNEY TRANSPLANTS. ITS CANCER CENTER OFFERS CANCER TREATMENT, THERAPIES AND ACCESS TO CLINICAL TRIALS. THE HOSPITAL OPERATES THE LARGEST, PRIVATE, HOSPITAL-BASED GROUND AND AIR AMBULANCE SHOCK-TRAUMA SERVICE IN THE REGION. IT ALSO OFFERS COMPREHENSIVE AMBULATORY CARE THROUGH A WIDE RANGE OF MEDICAL AND SURGICAL SPECIALTY OUTPATIENT CLINIC PROGRAMS. MWHC IS ADVANCED CERTIFIED BY THE JOINT COMMISSION AS A PRIMARY STROKE CENTER AND IN VENTRICULAR ASSIST DEVICE. IN 2013, US NEWS AND WORLD REPORT RECOGNIZED MWHC AS ONE OF THE NATION'S TOP 50 HOSPITALS IN CARDIOLOGY AND HEART SURGERY. THE HOSPITAL WAS THE RECIPIENT OF THE 2013 DELMARVA FOUNDATION FOR MEDICAL CARE'S EXCELLENCE AWARD FOR QUALITY IMPROVEMENT IN HOSPITALS.</Explanation>
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      <GeneralExplanation>
        <Identifier>ORGANIZATION MEMBERS</Identifier>
        <ReturnReference>PART VI, LINE 6</ReturnReference>
        <Explanation>THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS PART VI, LINE 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT &amp; CEO OF MEDSTAR HEALTH, INC.</Explanation>
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      <GeneralExplanation>
        <Identifier>DECISION OF GOVERNING BODY</Identifier>
        <ReturnReference>PART VI, LINE 7B</ReturnReference>
        <Explanation>AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE.</Explanation>
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      <GeneralExplanation>
        <Identifier>PROCESS FOR REVIEWING FORM 990</Identifier>
        <ReturnReference>PART VI, LINE 11</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>
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      <GeneralExplanation>
        <Identifier>CONFLICT OF INTEREST POLICY</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) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO 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>EQUITY TRANSFERS - NET ASSETS.................($10,948,332)</Explanation>
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        <TypeOfEntity>C CORP</TypeOfEntity>
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      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
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      <ExchangeOfAssets>false</ExchangeOfAssets>
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      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
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      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
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      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
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      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
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      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
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</Return>