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      <TotalOfAmounts>31465261</TotalOfAmounts>
      <Form990ScheduleDPartXIV>
        <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 TH 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, 2011.</Explanation>
      </Form990ScheduleDPartXIV>
    </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>8361158</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>8361158</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02120</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>0</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>0</NetCommunityBenefitExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>0</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>0</NetCommunityBenefitExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>8361158</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>8361158</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02120</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>2167651</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>6645</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2161006</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00550</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>17025647</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>17025647</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.04310</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>15487665</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>10289661</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>5198004</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01320</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <Research>
        <TotalCommunityBenefitExpense>1061881</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1061881</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00270</PercentOfTotalExpense>
      </Research>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>59361</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>59361</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00020</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>35802205</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>10296306</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>25505899</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.06470</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>44163363</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>10296306</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>33867057</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.08590</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <CommunitySupport>
        <TotalCommunityBuildingExpense>172418</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>29873</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>142545</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00040</PercentOfTotalExpense>
      </CommunitySupport>
      <HealthImprovementAdvocacy>
        <TotalCommunityBuildingExpense>29671</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>29671</NetCommunityBuildingExpense>
      </HealthImprovementAdvocacy>
      <WorkforceDevelopment>
        <TotalCommunityBuildingExpense>410</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>410</NetCommunityBuildingExpense>
      </WorkforceDevelopment>
      <Total>
        <TotalCommunityBuildingExpense>202499</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>29873</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>172626</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00040</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>9566299</BadDebtExpenseAmount>
      <AmountAttributableTo>0</AmountAttributableTo>
      <AmountReimbursedByMedicare>0</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>0</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>0</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>Union Memorial Hospital</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>201 East University Parkway</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21218</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <TeachingHospital>X</TeachingHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Union Memorial Hospital</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Identifier>CHARITY CARE AT COST</Identifier>
        <ReturnReference>PART I, LINE 7A</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>UNREIMBURSED MEDICAID</Identifier>
        <ReturnReference>PART I, LINE 7B</ReturnReference>
        <Explanation>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. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>HEALTH PROFESSIONS EDUCATION</Identifier>
        <ReturnReference>PART I, LINE 7F</ReturnReference>
        <Explanation>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. PERCENT OF TOTAL EXPENSE PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE OF $15,330,607 HAS BEEN REMOVED FROM TOTAL EXPENSE TO CALCULATE THE PERCENTAGE IN COLUMN (F).</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>BAD DEBT</Identifier>
        <ReturnReference>PART III, LINE 4</ReturnReference>
        <Explanation>MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND HFMA 15. AMOUNTS THAT ARE NOT EXPECTED TO BE COLLECTED, FOR PATIENTS QUALIFYING UNDER MEDSTAR HEALTH'S FINANCIAL ASSISTANCE POLICY, ARE WRITTEN OFF TO CHARITY CARE AND REPORTED AS A REDUCTION TO REVENUE. BAD DEBT EXPENSE RESULTS FROM MANAGEMENT'S INABILITY TO COLLECT REVENUES THAT MEET THE GAAP CRITERIA FOR REVENUE RECOGNITION. BAD DEBT REPRESENTS AN OPERATING EXPENSE AND IS REFLECTED AS A SEPARATE LINE ITEM ON THE ORGANIZATION'S STATEMENT OF OPERATIONS. 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>NEEDS ASSESSMENT</Identifier>
        <ReturnReference>PART VI, LINE 2</ReturnReference>
        <Explanation>AS A COMMUNITY PARTNER, MEDSTAR UNION MEMORIAL HOSPITAL (MUMH) WORKS COLLABORATIVELY WITH LOCAL PARTNERS TO IDENTIFY KEY HEALTH NEEDS. PARTNERS INCLUDE, BUT ARE NOT LIMITED TO: THE BALTIMORE CITY DEPARTMENT OF HEALTH, NOT-FOR-PROFIT AND SOCIAL SERVICE AGENCIES, SCHOOLS AND UNIVERSITIES, FAITH BASED ORGANIZATIONS AND COMMUNITY BASED COALITIONS. LOCAL, STATE AND NATIONAL HEALTH GOALS ARE ALSO USED TO ASSESS THE NEEDS OF THE COMMUNITY. IN ADDITION, HOSPITAL SERVICE UTILIZATION PATTERNS, SUCH AS THE CAUSES OF EMERGENCY ROOM VISITS AND INPATIENT ADMISSIONS HELP DETERMINE THE HEALTH NEEDS OF THE COMMUNITY. AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM MUMH ALSO 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 OR 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>GEOGRAPHIC: LOCATED IN BALTIMORE CITY, MEDSTAR UNION MEMORIAL HOSPITAL'S ACTIVITIES, EDUCATIONAL PROGRAMMING AND COMMUNITY PARTNERSHIPS ARE FOCUSED ON COMMUNITIES LOCATED IN ZIP CODES 21218, 21211, 21213, 21215, 21206, 21212, 21217 AND 21239. THIS INCLUDES THE COMMUNITIES OF ARLINGTON, CHARLES VILLAGE, CLIFTON-EAST END, DRUID, GOVANS, HAMILTON, HAMPDEN, NORTHWOOD, OVERLEA AND WAVERLY. DEMOGRAPHIC: THE POPULATION OF MEDSTAR UNION MEMORIAL HOSPITAL'S SERVICE AREA IS APPROXIMATELY TWO-THIRDS AFRICAN AMERICAN (63.5%) AND ONE-THIRD CAUCASIAN (33.5%) AND SPLIT ALMOST EVENLY BETWEEN MALES (46.6%) AND FEMALES (53.5%). THE MEDIAN AGE IS 34 YEARS AND AVERAGE LIFE EXPECTANCY IS 72.9 YEARS OF AGE. THE MEDIAN HOUSEHOLD INCOME IS $38,772, WITH 17.0% OF HOUSEHOLDS LIVING AT OR BELOW THE FEDERAL POVERTY LINE. ADDITIONALLY, AN ESTIMATED 9.5% OF BALTIMORE COUNTY RESIDENTS AND 15.2% OF BALTIMORE CITY RESIDENTS ARE UNINSURED, WHILE 8.5% AND 8.3% OF BALTIMORE COUNTY AND BALTIMORE CITY RESIDENTS, RESPECTIVELY, RECEIVE MEDICAID.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PROMOTION OF COMMUNITY HEALTH</Identifier>
        <ReturnReference>PART VI, LINE 5</ReturnReference>
        <Explanation>AS A COMMUNITY PARTNER, MUMH ENGAGES IN A NUMBER OF COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITY. A PARTNERSHIP WITH SHEPHERD'S CLINIC, A NURSE EXTERN PROGRAM, AND COMMUNITY SPONSORSHIPS ARE THREE EXAMPLES OF COMMUNITY BUILDING ACTIVITIES. SHEPHERD'S CLINIC IS A HEALTH CARE CLINIC FOR UNINSURED RESIDENTS OF BALTIMORE. A TEAM OF 250 VOLUNTEERS MANAGE APPROXIMATELY 4,000 PATIENT VISITS EACH YEAR. THE CLINIC MEETS A VITAL NEED, PROVIDING PRIMARY HEALTH CARE TO WORKING ADULTS AND THE UNEMPLOYED WHO ARE UNINSURED. MUMH DOCTORS, RETIRED DOCTORS, NURSES AND THERAPISTS ARE MAINSTAYS OF THE VOLUNTEER WORKFORCE, AND THE HOSPITAL'S THIRD-YEAR MEDICAL RESIDENTS EACH SPEND TWO TO FOUR WEEKS WORKING AT THE CLINIC. MUMH ALSO PROVIDES A PAID MEDICAL DIRECTOR AND SUPERVISOR. MEDSTAR UNION MEMORIAL HOSPITAL PROVIDES AN ASSORTMENT OF SUBSIDIES TO MEET THE NEEDS OF ITS PATIENT POPULATION AND ITS COMMUNITY. HOSPITALIST SUBSIDIES ENSURE 24/7 SERVICES IN THE HOSPITAL AND FOCUS ON PREVENTIVE HEALTH MEASURES AND HEALTH STATUS IMPROVEMENT FOR THE COMMUNITY. OUTPATIENT RENAL REIMBURSEMENT DOES NOT EXCEED THE COST OF PROVIDING THE PROGRAM, HOWEVER, RENAL SERVICES ARE NEEDED IN THE COMMUNITY AND THIS SERVICE IS PROVIDED AT A NEGATIVE MARGIN. OTHER SUBSIDIES INCLUDE PSYCHIATRY, EMERGENCY ROOM, AND PEDIATRIC SERVICES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>AFFILIATED HEALTH CARE SYSTEM</Identifier>
        <ReturnReference>PART VI, LINE 6</ReturnReference>
        <Explanation>AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR UNION MEMORIAL HOSPITAL 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 MEDSTAR UNION MEMORIAL HOSPITAL 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 UNION MEMORIAL HOSPITAL IS ONLY FILED IN THE STATE OF MARYLAND.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <ClubDuesOrFees>X</ClubDuesOrFees>
      <WrittenPolicyReTAndEExpenses>true</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>true</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>KENNETH A SAMET</NamePerson>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>1180163</CompBasedOnRelatedOrgs>
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        <BonusRelatedOrgs>1354791</BonusRelatedOrgs>
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        <DeferredCompRelatedOrgs>112797</DeferredCompRelatedOrgs>
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        <NontaxableBenefitsRelatedOrgs>19468</NontaxableBenefitsRelatedOrgs>
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        <TotalCompensationRelatedOrgs>3257359</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>HARRISON RIDER III</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>STUART BELL</NamePerson>
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        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>116136</BonusFilingOrg>
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        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>JOSEPH SMITH</NamePerson>
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        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>BRADLEY CHAMBERS</NamePerson>
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        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>LESLIE MATTHEWS MD</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>STEPHEN KOENIGSBERG</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>SHARON BOTTCHER</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>CHERYL LUNNEN</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>NEIL MACDONALD</NamePerson>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>RICHARD LEVINE</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>FRANK EBERT</NamePerson>
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        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>PAUL ASDOURIAN</NamePerson>
        <BaseCompensationFilingOrg>951089</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>25767</BonusFilingOrg>
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        <DeferredCompFilingOrg>188</DeferredCompFilingOrg>
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        <NontaxableBenefitsFilingOrg>18504</NontaxableBenefitsFilingOrg>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>HENRY BOUCHER</NamePerson>
        <BaseCompensationFilingOrg>824929</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>206172</BonusFilingOrg>
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        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
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        <DeferredCompFilingOrg>549</DeferredCompFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>JOHN WANG</NamePerson>
        <BaseCompensationFilingOrg>775718</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>8390</DeferredCompFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>PHILIP BUESCHER MD</NamePerson>
        <BaseCompensationFilingOrg>115373</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>6467</DeferredCompFilingOrg>
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        <NontaxableBenefitsFilingOrg>1286</NontaxableBenefitsFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>SOCIAL CLUB DUES</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 1</ReturnReference>
        <Explanation>THE ORGANIZATION PAID SOCIAL CLUB DUES FOR TWO 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. SUPPLEMENTAL RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B KENNETH SAMET KENNETH SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $568,506 REPRESENTING MR. SAMET'S ACCRUED BENEFIT IN A SUPPLEMENTAL RETIREMENT PLAN, WHICH WAS EARNED DURING THE PAST 22 YEARS OF SERVICE. THIS AMOUNT WAS NOT ACTUALLY PAID TO MR. SAMET, BUT WAS REPORTED AS COMPENSATION UNDER FICA TAX-REPORTING RULES. HARRISON RIDER HARRISON RIDER'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $143,394 REPRESENTING THE AMOUNT OF SUPPLEMENTAL RETIREMENT BENEFIT PAYMENTS RELATING TO PRIOR YEARS OF SERVICE. IN ADDITION, PART II, COLUMN (B)(III) INCLUDES $275,561 RELATING TO INCOME REALIZED IN THE CURRENT YEAR FROM A DISTRIBUTION TO MR. RIDER FROM A NONQUALIFIED DEFERRED COMPENSATION PLAN.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>GREATER CHESAPEAKE ORTHOPEDIC ASSOC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>See Schedule L, Part V</Relationship>
        <AmountOfTransaction>6700000</AmountOfTransaction>
        <DescriptionOfTransaction>Management &amp; support services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>GREATER CHESAPEAKE ORTHOPEDIC ASSOC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>See Schedule L, Part V</Relationship>
        <AmountOfTransaction>6700000</AmountOfTransaction>
        <DescriptionOfTransaction>Management &amp; support services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>GREATER CHESAPEAKE ORTHOPEDIC ASSOC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>See Schedule L, Part V</Relationship>
        <AmountOfTransaction>6700000</AmountOfTransaction>
        <DescriptionOfTransaction>Management &amp; support services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>GREATER CHESAPEAKE ORTHOPEDIC ASSOC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>See Schedule L, Part V</Relationship>
        <AmountOfTransaction>6700000</AmountOfTransaction>
        <DescriptionOfTransaction>Management &amp; support services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>GREATER CHESAPEAKE ORTHOPEDIC ASSOC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>See Schedule L, Part V</Relationship>
        <AmountOfTransaction>6700000</AmountOfTransaction>
        <DescriptionOfTransaction>Management &amp; support services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Identifier>BUSINESS TRANSACTION INVOLVING INTERESTED PERSON</Identifier>
        <ReturnReference>SCHEDULE L, PART IV</ReturnReference>
        <Explanation>DOCTORS LESLIE MATTHEWS (A BOARD MEMBER OF UNION MEMORIAL HOSPITAL), FRANK EBERT, RICHARD LEVINE, HENRY BOUCHER, AND PAUL ASDOURIAN (ALL HIGHLY COMPENSATED EMPLOYEES OF UNION MEMORIAL HOSPITAL) EACH OWN MORE THAN 5% OF GREATER CHESAPEAKE ORTHOPEDIC ASSOCIATES, LLC (GCOA), WHICH PROVIDES PRACTICE MANAGEMENT AND SUPPORT SERVICES TO UNION MEMORIAL HOSPITAL'S ORTHOPEDIC SURGEONS. GCOA'S GROSS REVENUES RECEIVED FROM THE HOSPITAL FOR THESE SERVICES FOR THE YEAR WAS $6.7M.</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>EXEMPT PURPOSE ACHIEVEMENTS</Identifier>
        <ReturnReference>PART III, LINE 4A</ReturnReference>
        <Explanation>THE HOSPITAL IS DESIGNATED BY THE U.S. CONGRESS AS A REGIONAL TRAUMA CENTER FOR HAND AND UPPER EXTREMITY INJURIES AND DISEASE AND IS RECOGNIZED AS AN ADVANCED PRIMARY STROKE CENTER BY THE JOINT COMMISSION. MUMH WAS RECOGNIZED BY US NEWS AND WORLD REPORT AS ONE OF THE NATION'S TOP 50 HOSPITALS FOR CARDIOLOGY AND HEART SURGERY, ORTHOPEDICS, AND DIABETES AND ENDOCRINOLOGY. FOR THE FIFTH CONSECUTIVE YEAR, THE HOSPITAL WAS THE RECIPIENT OF THE DELMARVA FOUNDATION MEDICARE EXCELLENCE AWARD FOR QUALITY IMPROVEMENT. ORGANIZATION MEMBERS PART VI, LINE 6 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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIPTION OF MEMEBRS</Identifier>
        <ReturnReference>PART VI, LINE 7A</ReturnReference>
        <Explanation>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>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DECISIONS OF GOVERNING BODY</Identifier>
        <ReturnReference>PART VII, 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>
      </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 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) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED.</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 STATEMENTS 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>FINANCIAL SATEMENTS AND REPORTING</Identifier>
        <ReturnReference>PART XI, LINE 2C</ReturnReference>
        <Explanation>THE UNION MEMORIAL HOSPITAL IS PART OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS</Identifier>
        <ReturnReference>PART XI, LINE 5</ReturnReference>
        <Explanation>EQUITY TRANSFERS- NET ASSETS..........................$ (21,047,119) UNREALIZED GAIN ON INVESTMENTS......................... 5,933,450 ============= TOTAL $ (15,113,669)</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:KENNETH A SAMET TITLE:DIRECTOR HOURS:40</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medstar Health Anesthesia Services D LLC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>201 East University Parkway</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21218</ZIPCode>
        </AddressUS>
        <EIN>205909921</EIN>
        <PrimaryActivities>Health Svcs</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <TotalIncome>10954193</TotalIncome>
        <EOYAssets>1737090</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
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      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BaltimoreWashington Pathology Group LLC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>201 East University Parkway</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21218</ZIPCode>
        </AddressUS>
        <EIN>522242146</EIN>
        <PrimaryActivities>Health SVCS</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <TotalIncome>784182</TotalIncome>
        <EOYAssets>190386</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartI>
      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Union Memorial Imaging LLC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>201 East University Parkway</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21218</ZIPCode>
        </AddressUS>
        <EIN>272549579</EIN>
        <PrimaryActivities>Health Svcs</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <TotalIncome>2415643</TotalIncome>
        <EOYAssets>428252</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartI>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Church Home Corporation</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
          <City>Columbia</City>
          <State>MD</State>
          <ZIPCode>21044</ZIPCode>
        </AddressUS>
        <EIN>237374724</EIN>
        <PrimaryActivities>Medical Fund</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>PF</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Franklin Square Hospital Center Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>9000 Franklin Square Drive</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21237</ZIPCode>
        </AddressUS>
        <EIN>520608007</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Harbor Hospital Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>3001 South Hanover Street</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21225</ZIPCode>
        </AddressUS>
        <EIN>520491660</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medstar Health Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
          <City>Columbia</City>
          <State>MD</State>
          <ZIPCode>21044</ZIPCode>
        </AddressUS>
        <EIN>522087445</EIN>
        <PrimaryActivities>Medical Svcs</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11b II</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Montgomery General Hospital</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>18101 Prince Philip Drive</AddressLine1>
          <City>Olney</City>
          <State>MD</State>
          <ZIPCode>20832</ZIPCode>
        </AddressUS>
        <EIN>520646893</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>The Good Samaritan Hospital of Maryland</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5601 Loch Raven Blvd</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21239</ZIPCode>
        </AddressUS>
        <EIN>520591607</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medstar Research Institute</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>108 Irving Street NW</AddressLine1>
          <City>Washington</City>
          <State>DC</State>
          <ZIPCode>20010</ZIPCode>
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        <EIN>526056274</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>DC</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>The Medstar-Georgetown Medical Center I</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>Hopsital Admin 1 Main Bldg</AddressLine1>
          <City>Washington</City>
          <State>DC</State>
          <ZIPCode>20007</ZIPCode>
        </AddressUS>
        <EIN>522218584</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>DC</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Washington Hospital Center Corporation</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>110 Irving Street NW</AddressLine1>
          <City>Washington</City>
          <State>DC</State>
          <ZIPCode>20010</ZIPCode>
        </AddressUS>
        <EIN>521272129</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>DC</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>HH Medstar Health Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
          <City>Columbia</City>
          <State>MD</State>
          <ZIPCode>21044</ZIPCode>
        </AddressUS>
        <EIN>521542230</EIN>
        <PrimaryActivities>Medical Svcs</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11b II</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Bay Development Corp</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
          <City>Columbia</City>
          <State>MD</State>
          <ZIPCode>21044</ZIPCode>
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        <EIN>521132992</EIN>
        <PrimaryActivities>Foundation</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11a I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Bay Life Services Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
          <City>Columbia</City>
          <State>MD</State>
          <ZIPCode>21044</ZIPCode>
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        <EIN>521496539</EIN>
        <PrimaryActivities>Mental Health</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MedStar Surgery Center Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>4061 Powdermill Road Suite 210</AddressLine1>
          <City>Calverton</City>
          <State>MD</State>
          <ZIPCode>20705</ZIPCode>
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        <EIN>521061679</EIN>
        <PrimaryActivities>Medical Svcs</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
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        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Church Home and Hospital of the City of</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
          <City>Columbia</City>
          <State>MD</State>
          <ZIPCode>21044</ZIPCode>
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        <EIN>520591600</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
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        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Foundation for Georgetown University Hos</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>Hopsital Admin 1 Main Bldg</AddressLine1>
          <City>Washington</City>
          <State>DC</State>
          <ZIPCode>20007</ZIPCode>
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        <LegalDomicileState>DC</LegalDomicileState>
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        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
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          <BusinessNameLine1>Franklin Square Hospital Center Foundati</BusinessNameLine1>
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          <AddressLine1>9000 Franklin Square Drive</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21237</ZIPCode>
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        <LegalDomicileState>MD</LegalDomicileState>
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          <BusinessNameLine1>NA</BusinessNameLine1>
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          <AddressLine1>5601 Loch Raven Blvd</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21239</ZIPCode>
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          <BusinessNameLine1>NA</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>5601 Loch Raven Blvd</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21239</ZIPCode>
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          <BusinessNameLine1>NA</BusinessNameLine1>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>GS Housing Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>5601 Loch Raven Blvd</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21239</ZIPCode>
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        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
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        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>GS Properties Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>5601 Loch Raven Blvd</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21239</ZIPCode>
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        <EIN>521429853</EIN>
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        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11a I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Harbor Hospital Foundation Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>3001 South Hanover Street</AddressLine1>
          <City>Baltimore</City>
          <State>MD</State>
          <ZIPCode>21225</ZIPCode>
        </AddressUS>
        <EIN>521284532</EIN>
        <PrimaryActivities>Foundation</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11a I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medstar Health Infusion Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>4061 Powdermill Road Suite 210</AddressLine1>
          <City>Calverton</City>
          <State>MD</State>
          <ZIPCode>20705</ZIPCode>
        </AddressUS>
        <EIN>521980510</EIN>
        <PrimaryActivities>Medical Svcs</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medstar Health Visiting Nurses Associati</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>4061 Powdermill Road</AddressLine1>
          <City>Calverton</City>
          <State>MD</State>
          <ZIPCode>20705</ZIPCode>
        </AddressUS>
        <EIN>530196597</EIN>
        <PrimaryActivities>Medical Svcs</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medstar Long Term Care Corporation</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>4061 Powdermill Road Suite 210</AddressLine1>
          <City>Calverton</City>
          <State>MD</State>
          <ZIPCode>20705</ZIPCode>
        </AddressUS>
        <EIN>521489097</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medstar VNA Healthcare</BusinessNameLine1>
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        <LegalDomicileState>MD</LegalDomicileState>
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          <BusinessNameLine1>Franklin Square Drive Land Condo Associa</BusinessNameLine1>
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          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
          <City>Columbia</City>
          <State>MD</State>
          <ZIPCode>21044</ZIPCode>
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        <PrimaryActivity>CONDO OWNER ASSOC</PrimaryActivity>
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          <City>Olney</City>
          <State>MD</State>
          <ZIPCode>20832</ZIPCode>
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          <BusinessNameLine1>St Mary's Health Alliance Inc</BusinessNameLine1>
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          <City>Leonardtown</City>
          <State>MD</State>
          <ZIPCode>20650</ZIPCode>
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        <TypeOfEntity>C Corp</TypeOfEntity>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Greenspring Financial Insurance Limited</BusinessNameLine1>
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        <EIN>980188617</EIN>
        <PrimaryActivity>Insurance</PrimaryActivity>
        <LegalDomicileForeignCountry>CJ</LegalDomicileForeignCountry>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C Corp</TypeOfEntity>
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      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
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  </ReturnData>
</Return>