﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2010v3.2">
  <ReturnHeader binaryAttachmentCount="0">
    <Timestamp>2012-08-14T12:00:09-05:00</Timestamp>
    <TaxPeriodEndDate>2011-09-30</TaxPeriodEndDate>
    <PreparerFirm>
      <PreparerFirmBusinessName>
        <BusinessNameLine1>CROWE HORWATH LLP</BusinessNameLine1>
      </PreparerFirmBusinessName>
      <PreparerFirmUSAddress>
        <AddressLine1>401 East Las Olas Blvd</AddressLine1>
        <AddressLine2>Suite 1100</AddressLine2>
        <City>Fort Lauderdale</City>
        <State>FL</State>
        <ZIPCode>33301</ZIPCode>
      </PreparerFirmUSAddress>
    </PreparerFirm>
    <ReturnType>990</ReturnType>
    <TaxPeriodBeginDate>2010-10-01</TaxPeriodBeginDate>
    <Filer>
      <EIN>592447553</EIN>
      <Name>
        <BusinessNameLine1>BETHESDA HEALTHCARE SYSTEM INC</BusinessNameLine1>
      </Name>
      <NameControl>BETH</NameControl>
      <Phone>5617377733</Phone>
      <USAddress>
        <AddressLine1>2815 S Seacrest Blvd</AddressLine1>
        <City>Boynton Beach</City>
        <State>FL</State>
        <ZIPCode>33435</ZIPCode>
      </USAddress>
    </Filer>
    <Officer>
      <Name>JOANNE AQUILINA</Name>
      <Title>CFO</Title>
      <DateSigned>2012-08-08</DateSigned>
      <AuthorizeThirdParty>true</AuthorizeThirdParty>
    </Officer>
    <Preparer>
      <Phone>9542028600</Phone>
    </Preparer>
    <TaxYear>2010</TaxYear>
    <BuildTS>2016-02-24 21:20:13Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCount="9">
    <IRS990 documentId="IRS990" softwareId="10000128" softwareVersion="v2010.1.0" referenceDocumentId="IRS990ScheduleO">
      <NameOfPrincipalOfficerBusiness>
        <BusinessNameLine1>ROGER L KIRK</BusinessNameLine1>
      </NameOfPrincipalOfficerBusiness>
      <AddressPrincipalOfficerUS>
        <AddressLine1>2815 S Seacrest Blvd</AddressLine1>
        <City>Boynton Beach</City>
        <State>FL</State>
        <ZIPCode>33435</ZIPCode>
      </AddressPrincipalOfficerUS>
      <GrossReceipts>94941673</GrossReceipts>
      <GroupReturnForAffiliates>false</GroupReturnForAffiliates>
      <Organization501c3>X</Organization501c3>
      <WebSite>WWW.BETHESDAWEB.COM</WebSite>
      <TypeOfOrganizationCorporation>X</TypeOfOrganizationCorporation>
      <YearFormation>1984</YearFormation>
      <StateLegalDomicile>FL</StateLegalDomicile>
      <ActivityOrMissionDescription>TO PROVIDE MANAGEMENT AND SUPPORT SERVICES NECESSARY FOR THE OPERATION OF BETHESDA MEMORIAL HOSPITAL, INC. AND AFFILIATED ORGANIZATIONS.</ActivityOrMissionDescription>
      <NbrVotingMembersGoverningBody>8</NbrVotingMembersGoverningBody>
      <NbrIndependentVotingMembers>8</NbrIndependentVotingMembers>
      <TotalNbrEmployees>176</TotalNbrEmployees>
      <TotalNbrVolunteers>0</TotalNbrVolunteers>
      <TotalGrossUBI>547198</TotalGrossUBI>
      <NetUnrelatedBusinessTxblIncome>29953</NetUnrelatedBusinessTxblIncome>
      <ContributionsGrantsPriorYear>0</ContributionsGrantsPriorYear>
      <ContributionsGrantsCurrentYear>0</ContributionsGrantsCurrentYear>
      <ProgramServiceRevenuePriorYear>13712209</ProgramServiceRevenuePriorYear>
      <ProgramServiceRevenueCY>14641963</ProgramServiceRevenueCY>
      <InvestmentIncomePriorYear>3475229</InvestmentIncomePriorYear>
      <InvestmentIncomeCurrentYear>6245487</InvestmentIncomeCurrentYear>
      <OtherRevenuePriorYear>1260838</OtherRevenuePriorYear>
      <OtherRevenueCurrentYear>922137</OtherRevenueCurrentYear>
      <TotalRevenuePriorYear>18448276</TotalRevenuePriorYear>
      <TotalRevenueCurrentYear>21809587</TotalRevenueCurrentYear>
      <GrantsAndSimilarAmntsPriorYear>0</GrantsAndSimilarAmntsPriorYear>
      <GrantsAndSimilarAmntsCY>61550</GrantsAndSimilarAmntsCY>
      <BenefitsPaidToMembersPriorYear>0</BenefitsPaidToMembersPriorYear>
      <BenefitsPaidToMembersCY>0</BenefitsPaidToMembersCY>
      <SalariesEtcPriorYear>11606081</SalariesEtcPriorYear>
      <SalariesEtcCurrentYear>12103660</SalariesEtcCurrentYear>
      <TotalProfFundrsngExpPriorYear>0</TotalProfFundrsngExpPriorYear>
      <TotalProfFundrsngExpCY>0</TotalProfFundrsngExpCY>
      <TotalFundrsngExpCurrentYear>0</TotalFundrsngExpCurrentYear>
      <OtherExpensePriorYear>8524611</OtherExpensePriorYear>
      <OtherExpensesCurrentYear>9004200</OtherExpensesCurrentYear>
      <TotalExpensesPriorYear>20130692</TotalExpensesPriorYear>
      <TotalExpensesCurrentYear>21169410</TotalExpensesCurrentYear>
      <RevenuesLessExpensesPriorYear>-1682416</RevenuesLessExpensesPriorYear>
      <RevenuesLessExpensesCY>640177</RevenuesLessExpensesCY>
      <TotalAssetsBOY>175872552</TotalAssetsBOY>
      <TotalAssetsEOY>195515875</TotalAssetsEOY>
      <TotalLiabilitiesBOY>154961634</TotalLiabilitiesBOY>
      <TotalLiabilitiesEOY>169009859</TotalLiabilitiesEOY>
      <NetAssetsOrFundBalancesBOY>20910918</NetAssetsOrFundBalancesBOY>
      <NetAssetsOrFundBalancesEOY>26506016</NetAssetsOrFundBalancesEOY>
      <MissionDescription>BETHESDA HEALTHCARE SYSTEM, INC'S MISSION IS TO PROVIDE THE MANAGEMENT AND SUPPORT SERVICES NECESSARY FOR THE OPERATION OF BETHESDA MEMORIAL HOSPITAL, INC. AND AFFILIATED ORGANIZATIONS, WHICH PROVIDE QUALITY HEALTHCARE SERVICES IN A CARING MANNER. THE CORPORATION, AND ITS AFFILIATES, FUNCTION AS A VERTICALLY INTEGRATED PROVIDER OF A BROAD SPECTRUM OF INPATIENT, OUTPATIENT AND HOME-CARE HEALTHCARE SERVICES THROUGHOUT THE COMMUNITY.</MissionDescription>
      <SignificantNewProgramServices>false</SignificantNewProgramServices>
      <SignificantChange>false</SignificantChange>
      <Expense>18203518</Expense>
      <Revenue>14811604</Revenue>
      <Description>BETHESDA HEALTHCARE SYSTEM MANAGES ACTIVITIES DESIGNED TO SUPPORT AND FURTHER THE PUBLIC HEALTH, MEDICAL AND SOCIAL PURPOSES OF ITS COMMUNITY BY PROVIDING MANAGEMENT SERVICES TO BETHESDA MEMORIAL HOSPITAL AND AFFILIATED ORGANIZATIONS.</Description>
      <TotalProgramServiceExpense>18203518</TotalProgramServiceExpense>
      <DescribedIn501C3 referenceDocumentId="IRS990ScheduleA">true</DescribedIn501C3>
      <ScheduleBRequired>false</ScheduleBRequired>
      <PoliticalActivities>false</PoliticalActivities>
      <LobbyingActivities referenceDocumentId="IRS990ScheduleC">true</LobbyingActivities>
      <DonorAdvisedFunds>false</DonorAdvisedFunds>
      <ConservationEasements>false</ConservationEasements>
      <CollectionsOfArt>false</CollectionsOfArt>
      <CreditCounseling>false</CreditCounseling>
      <TermOrPermanentEndowments referenceDocumentId="IRS990ScheduleD">true</TermOrPermanentEndowments>
      <ReportLandBldgEquip referenceDocumentId="IRS990ScheduleD">true</ReportLandBldgEquip>
      <ReportInvestOthSecurities>false</ReportInvestOthSecurities>
      <ReportProgRelInvest>false</ReportProgRelInvest>
      <ReportOtherAssets>false</ReportOtherAssets>
      <ReportOtherLiabilities referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilities>
      <ReportFin48Footnote referenceDocumentId="IRS990ScheduleD">true</ReportFin48Footnote>
      <IndependentAuditFinancialStmt>false</IndependentAuditFinancialStmt>
      <ConsolidatedAuditFinancialStmt referenceDocumentId="IRS990ScheduleD">true</ConsolidatedAuditFinancialStmt>
      <School>false</School>
      <ForeignOffice>false</ForeignOffice>
      <ForeignActivities>false</ForeignActivities>
      <MoreThan5000KToOrganizations>false</MoreThan5000KToOrganizations>
      <MoreThan5000KToIndividuals>false</MoreThan5000KToIndividuals>
      <ProfessionalFundraising>false</ProfessionalFundraising>
      <FundraisingActivities>false</FundraisingActivities>
      <Gaming>false</Gaming>
      <Hospital>false</Hospital>
      <GrantsToOrganizations referenceDocumentId="IRS990ScheduleI">true</GrantsToOrganizations>
      <GrantsToIndividuals>false</GrantsToIndividuals>
      <ScheduleJRequired referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequired>
      <TaxExemptBonds referenceDocumentId="IRS990ScheduleK1">true</TaxExemptBonds>
      <InvestTaxExemptBonds>false</InvestTaxExemptBonds>
      <EscrowAccount>false</EscrowAccount>
      <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
      <ExcessBenefitTransaction>false</ExcessBenefitTransaction>
      <PriorExcessBenefitTransaction>false</PriorExcessBenefitTransaction>
      <LoanToOfficerOrDQP>false</LoanToOfficerOrDQP>
      <GrantToRelatedPerson>false</GrantToRelatedPerson>
      <BsnssRltnshpWithOrganization>false</BsnssRltnshpWithOrganization>
      <BsnssRltnshpThruFamilyMember>false</BsnssRltnshpThruFamilyMember>
      <OfficerEntityWithBsnssRltnshp>false</OfficerEntityWithBsnssRltnshp>
      <DeductibleNonCashContributions>false</DeductibleNonCashContributions>
      <DeductibleContributionsOfArt>false</DeductibleContributionsOfArt>
      <Terminated>false</Terminated>
      <PartialLiquidation>false</PartialLiquidation>
      <DisregardedEntity>false</DisregardedEntity>
      <RelatedEntity referenceDocumentId="IRS990ScheduleR">true</RelatedEntity>
      <RelatedOrgControlledEntity>true</RelatedOrgControlledEntity>
      <TransactionRelatedEntity referenceDocumentId="IRS990ScheduleR">true</TransactionRelatedEntity>
      <TransfersToExemptNonChrtblOrg>false</TransfersToExemptNonChrtblOrg>
      <ActivitiesConductedPartnership>false</ActivitiesConductedPartnership>
      <ScheduleORequired>true</ScheduleORequired>
      <NumberFormsTransmittedWith1096>78</NumberFormsTransmittedWith1096>
      <NumberW2GIncluded>0</NumberW2GIncluded>
      <ComplianceWithBackupWitholding>true</ComplianceWithBackupWitholding>
      <NumberOfEmployees>176</NumberOfEmployees>
      <EmploymentTaxReturnsFiled>true</EmploymentTaxReturnsFiled>
      <UnrelatedBusinessIncome>true</UnrelatedBusinessIncome>
      <Form990-TFiled>true</Form990-TFiled>
      <ForeignFinancialAccount>false</ForeignFinancialAccount>
      <ProhibitedTaxShelterTrans>false</ProhibitedTaxShelterTrans>
      <TaxablePartyNotification>false</TaxablePartyNotification>
      <NonDeductibleContributions>false</NonDeductibleContributions>
      <QuidProQuoContributions>false</QuidProQuoContributions>
      <Form8282PropertyDisposedOf>false</Form8282PropertyDisposedOf>
      <FundsToPayPremiums>false</FundsToPayPremiums>
      <PremiumsPaid>false</PremiumsPaid>
      <ExcessBusinessHoldings>false</ExcessBusinessHoldings>
      <IndoorTanningServices>false</IndoorTanningServices>
      <InfoInScheduleOPartVI>X</InfoInScheduleOPartVI>
      <NbrVotingGoverningBodyMembers>8</NbrVotingGoverningBodyMembers>
      <NumberIndependentVotingMembers>8</NumberIndependentVotingMembers>
      <FamilyOrBusinessRelationship>false</FamilyOrBusinessRelationship>
      <DelegationOfManagementDuties>false</DelegationOfManagementDuties>
      <ChangesToOrganizingDocs>false</ChangesToOrganizingDocs>
      <MaterialDiversionOrMisuse>false</MaterialDiversionOrMisuse>
      <MembersOrStockholders>false</MembersOrStockholders>
      <ElectionOfBoardMembers>false</ElectionOfBoardMembers>
      <DecisionsSubjectToApproval>false</DecisionsSubjectToApproval>
      <MinutesOfGoverningBody>true</MinutesOfGoverningBody>
      <MinutesOfCommittees>true</MinutesOfCommittees>
      <OfficerMailingAddress>false</OfficerMailingAddress>
      <LocalChapters>false</LocalChapters>
      <Form990ProvidedToGoverningBody>true</Form990ProvidedToGoverningBody>
      <ConflictOfInterestPolicy>true</ConflictOfInterestPolicy>
      <AnnualDisclosureCoveredPersons>true</AnnualDisclosureCoveredPersons>
      <RegularMonitoringEnforcement>true</RegularMonitoringEnforcement>
      <WhistleblowerPolicy>true</WhistleblowerPolicy>
      <DocumentRetentionPolicy>true</DocumentRetentionPolicy>
      <CompensationProcessCEO>true</CompensationProcessCEO>
      <CompensationProcessOther>true</CompensationProcessOther>
      <InvestmentInJointVenture>false</InvestmentInJointVenture>
      <UponRequest>X</UponRequest>
      <TheBooksAreInCareOf>
        <NameBusiness>
          <BusinessNameLine1>Donna Seymour</BusinessNameLine1>
        </NameBusiness>
        <TelephoneNumber>5617377733</TelephoneNumber>
        <AddressUS>
          <AddressLine1>2815 S Seacrest Blvd</AddressLine1>
          <City>Boynton Beach</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
      </TheBooksAreInCareOf>
      <InfoInScheduleOPartVII>X</InfoInScheduleOPartVII>
      <Form990PartVIISectionA>
        <NamePerson>ROBERT B HILL</NamePerson>
        <Title>PRESIDENT</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>876411</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>85600</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ROGER L KIRK</NamePerson>
        <Title>EXECUTIVE VICE PRESIDENT</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>375742</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>71464</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>JOANNE AQUILINA</NamePerson>
        <Title>CHIEF FINANCIAL OFFICER</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>246874</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>44902</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ROBERT BROADWAY</NamePerson>
        <Title>VP OF CORPORATE STRATEGY</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <KeyEmployee>X</KeyEmployee>
        <ReportableCompFromOrganization>203219</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>49870</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>STORMET C NOREM</NamePerson>
        <Title>MEMBER</Title>
        <AverageHoursPerWeek>2</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>WILLIAM F KOCH JR</NamePerson>
        <Title>CHAIRMAN</Title>
        <AverageHoursPerWeek>2</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>FRED B DEVITT JR ESQ</NamePerson>
        <Title>VICE CHAIRMAN</Title>
        <AverageHoursPerWeek>2</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>GEORGE T ELMORE</NamePerson>
        <Title>SECRETARY</Title>
        <AverageHoursPerWeek>2</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>THOMAS A SMITH</NamePerson>
        <Title>MEMBER</Title>
        <AverageHoursPerWeek>2</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>WILLIAM F CASSADY</NamePerson>
        <Title>MEMBER</Title>
        <AverageHoursPerWeek>2</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>NM WEEMS MD</NamePerson>
        <Title>MEMBER</Title>
        <AverageHoursPerWeek>2</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>FRED W LOVE MD</NamePerson>
        <Title>MEMBER</Title>
        <AverageHoursPerWeek>2</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>REGINA CRAFA</NamePerson>
        <Title>VP OF HUMAN RESOURCES</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>182244</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>25328</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>MICHAEL BROWN</NamePerson>
        <Title>INTERNAL AUDITOR</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>138324</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>24501</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>LESLIE DURHAM</NamePerson>
        <Title>VP OF INFORMATION SYSTEMS</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>141577</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>41194</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>GARY RITSON</NamePerson>
        <Title>VICE PRESIDENT RISK MANAGEMENT</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>120514</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>36707</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>DONNA SEYMOUR</NamePerson>
        <Title>CONTROLLER</Title>
        <AverageHoursPerWeek>40</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>117667</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>24722</OtherCompensation>
      </Form990PartVIISectionA>
      <TotalReportableCompFromOrg>2402572</TotalReportableCompFromOrg>
      <TotalReportableCompFrmRltdOrgs>0</TotalReportableCompFrmRltdOrgs>
      <TotalOtherCompensation>404288</TotalOtherCompensation>
      <NumberIndividualsGT100K>13</NumberIndividualsGT100K>
      <FormersListed>false</FormersListed>
      <TotalCompGT150K>true</TotalCompGT150K>
      <CompensationFromOtherSources>false</CompensationFromOtherSources>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>INGENIX INC</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>2771 MOMENTUM PLACE</AddressLine1>
            <City>CHICAGO</City>
            <State>IL</State>
            <ZIPCode>606895327</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>MANAGEMENT CONSULTING COMPANY</DescriptionOfServices>
        <Compensation>534175</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>HDR INC</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO BOX 3480</AddressLine1>
            <City>OMAHA</City>
            <State>NE</State>
            <ZIPCode>681030480</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>ARCHITECTURE</DescriptionOfServices>
        <Compensation>516396</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>ACOUSTI ENGINEERING CO OF FLORIDA</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>1530 53RD STREET</AddressLine1>
            <City>WEST PALM BEACH</City>
            <State>FL</State>
            <ZIPCode>33407</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>ENGINEERING</DescriptionOfServices>
        <Compensation>355777</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>BERNARD HODES GROUP</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO BOX 7517</AddressLine1>
            <City>CHARLOTTE</City>
            <State>NC</State>
            <ZIPCode>282751741</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>ADVERTISEMENT</DescriptionOfServices>
        <Compensation>257928</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>BALLARD PARTNERS INC</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>403 EAST PARK</AddressLine1>
            <City>TALLAHASSEE</City>
            <State>FL</State>
            <ZIPCode>32301</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>LOBBYING</DescriptionOfServices>
        <Compensation>205662</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>11</NumberOfContractorsGT100K>
      <TotalContributions>0</TotalContributions>
      <ProgramServiceRevenue>
        <Description>MANAGEMENT FEE - AFFILIATED COMPANIES</Description>
        <BusinessCode>561000</BusinessCode>
        <TotalRevenueColumn>14641963</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>14641963</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalOthProgramServiceRevenue>
        <TotalRevenueColumn>0</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>0</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>0</UnrelatedBusinessRevenue>
        <ExclusionAmount>0</ExclusionAmount>
      </TotalOthProgramServiceRevenue>
      <TotalProgramServiceRevenue>14641963</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>2227409</TotalRevenueColumn>
        <ExclusionAmount>2227409</ExclusionAmount>
      </InvestmentIncome>
      <IncomeFromInvestBondProceeds>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </IncomeFromInvestBondProceeds>
      <RoyaltiesRevenue>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </RoyaltiesRevenue>
      <GrossRents>
        <Real>1297576</Real>
      </GrossRents>
      <LessRentalExpenses>
        <Real>1080126</Real>
      </LessRentalExpenses>
      <RentalIncomeOrLoss>
        <Real>217450</Real>
        <Personal>0</Personal>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>217450</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>73182</UnrelatedBusinessRevenue>
        <ExclusionAmount>144268</ExclusionAmount>
      </NetRentalIncomeOrLoss>
      <GrossAmountSalesAssets>
        <Securities>76070038</Securities>
      </GrossAmountSalesAssets>
      <LessCostOthBasisSalesExpenses>
        <Securities>72051960</Securities>
      </LessCostOthBasisSalesExpenses>
      <GainOrLoss>
        <Securities>4018078</Securities>
        <Other>0</Other>
      </GainOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>4018078</TotalRevenueColumn>
        <ExclusionAmount>4018078</ExclusionAmount>
      </NetGainOrLossInvestments>
      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromGaming>
      <NetIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeOrLoss>
      <OtherRevenueMisc>
        <Description>ANSWERING SERVICE</Description>
        <BusinessCode>561000</BusinessCode>
        <TotalRevenueColumn>452380</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>452380</UnrelatedBusinessRevenue>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>SCM ALLIANCE FEE</Description>
        <BusinessCode>541200</BusinessCode>
        <TotalRevenueColumn>20000</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>20000</UnrelatedBusinessRevenue>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>REBATES</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>123563</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>123563</RelatedOrExemptFunctionIncome>
      </OtherRevenueMisc>
      <MiscellaneousRevenue>
        <TotalRevenueColumn>108744</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>46078</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>1636</UnrelatedBusinessRevenue>
        <ExclusionAmount>61030</ExclusionAmount>
      </MiscellaneousRevenue>
      <TotalOtherRevenue>704687</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>21809587</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>14811604</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>547198</UnrelatedBusinessRevenue>
        <ExclusionAmount>6450785</ExclusionAmount>
      </TotalRevenue>
      <GrantsToDomesticOrgs>
        <Total>61550</Total>
        <ProgramServices>61550</ProgramServices>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>1722011</Total>
        <ProgramServices>1498149</ProgramServices>
        <ManagementAndGeneral>223862</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>8032728</Total>
        <ProgramServices>6915677</ProgramServices>
        <ManagementAndGeneral>1117051</ManagementAndGeneral>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>797646</Total>
        <ProgramServices>686501</ProgramServices>
        <ManagementAndGeneral>111145</ManagementAndGeneral>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>916660</Total>
        <ProgramServices>650056</ProgramServices>
        <ManagementAndGeneral>266604</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>634615</Total>
        <ProgramServices>547296</ProgramServices>
        <ManagementAndGeneral>87319</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>30598</Total>
        <ManagementAndGeneral>30598</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>115947</Total>
        <ManagementAndGeneral>115947</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>257676</Total>
        <ProgramServices>257676</ProgramServices>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>496353</Total>
        <ManagementAndGeneral>496353</ManagementAndGeneral>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>527279</Total>
        <ProgramServices>351906</ProgramServices>
        <ManagementAndGeneral>175373</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>982659</Total>
        <ProgramServices>982659</ProgramServices>
      </Advertising>
      <OfficeExpenses>
        <Total>273590</Total>
        <ProgramServices>250161</ProgramServices>
        <ManagementAndGeneral>23429</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>184382</Total>
        <ProgramServices>184382</ProgramServices>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>660013</Total>
        <ProgramServices>455178</ProgramServices>
        <ManagementAndGeneral>204835</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>61492</Total>
        <ProgramServices>54409</ProgramServices>
        <ManagementAndGeneral>7083</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>35455</Total>
        <ProgramServices>7091</ProgramServices>
        <ManagementAndGeneral>28364</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>4339583</Total>
        <ProgramServices>4339583</ProgramServices>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>421144</Total>
        <ProgramServices>382420</ProgramServices>
        <ManagementAndGeneral>38724</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>50970</Total>
        <ProgramServices>44165</ProgramServices>
        <ManagementAndGeneral>6805</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>RECRUITING</Description>
        <Total>534659</Total>
        <ProgramServices>534659</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>FOREIGN TAXES PAID</Description>
        <Total>32400</Total>
        <ManagementAndGeneral>32400</ManagementAndGeneral>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>21169410</Total>
        <ProgramServices>18203518</ProgramServices>
        <ManagementAndGeneral>2965892</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <TotalJointCosts>
        <Total>0</Total>
      </TotalJointCosts>
      <CashNonInterestBearing>
        <BOY>30608542</BOY>
        <EOY>22112110</EOY>
      </CashNonInterestBearing>
      <AccountsReceivable>
        <BOY>155792</BOY>
        <EOY>141381</EOY>
      </AccountsReceivable>
      <OtherNotesLoansReceivableNet>
        <BOY>27321</BOY>
        <EOY>6920</EOY>
      </OtherNotesLoansReceivableNet>
      <PrepaidExpensesDeferredCharges>
        <BOY>179905</BOY>
        <EOY>227375</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>97135783</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>3777360</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>47205229</BOY>
        <EOY>93358423</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
        <BOY>90105603</BOY>
        <EOY>71795810</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsOtherSecurities>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </InvestmentsOtherSecurities>
      <InvestmentsProgramRelated>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </InvestmentsProgramRelated>
      <OtherAssetsTotal>
        <BOY>7590160</BOY>
        <EOY>7873856</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>175872552</BOY>
        <EOY>195515875</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>7949711</BOY>
        <EOY>9895377</EOY>
      </AccountsPayableAccruedExpenses>
      <TaxExemptBondLiabilities>
        <BOY>128223363</BOY>
        <EOY>128313553</EOY>
      </TaxExemptBondLiabilities>
      <MortNotesPyblSecuredInvestProp>
        <BOY>2845119</BOY>
        <EOY>16922666</EOY>
      </MortNotesPyblSecuredInvestProp>
      <OtherLiabilities>
        <BOY>15943441</BOY>
        <EOY>13878263</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>154961634</BOY>
        <EOY>169009859</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>20910918</BOY>
        <EOY>26506016</EOY>
      </UnrestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>20910918</BOY>
        <EOY>26506016</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>175872552</BOY>
        <EOY>195515875</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>640177</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>4954921</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="10000128" softwareVersion="v2010.1.0">
      <SupportingOrganization509a3>X</SupportingOrganization509a3>
      <SupportingOrg509a3Type3FuncInt>X</SupportingOrg509a3Type3FuncInt>
      <CertificationCheckbox>X</CertificationCheckbox>
      <ContribByControllingIndividual>false</ContribByControllingIndividual>
      <ContributionByRelatedParty>false</ContributionByRelatedParty>
      <ContribBy35ControlledEntity>false</ContribBy35ControlledEntity>
      <SupportedOrgInformation>
        <Name>
          <BusinessNameLine1>BETHESDA MEMORIAL HOSPITAL</BusinessNameLine1>
        </Name>
        <EIN>592447554</EIN>
        <TypeOfOrganization>3</TypeOfOrganization>
        <ListedInGoverningDoc>true</ListedInGoverningDoc>
        <SupportedOrganizationNotified>true</SupportedOrganizationNotified>
        <OrganizedInUS>true</OrganizedInUS>
        <Amount>10065860</Amount>
      </SupportedOrgInformation>
      <SupportedOrgInformation>
        <Name>
          <BusinessNameLine1>BETHESDA HEALTH CITY INC</BusinessNameLine1>
        </Name>
        <EIN>650561263</EIN>
        <TypeOfOrganization>9</TypeOfOrganization>
        <ListedInGoverningDoc>true</ListedInGoverningDoc>
        <SupportedOrganizationNotified>true</SupportedOrganizationNotified>
        <OrganizedInUS>true</OrganizedInUS>
        <Amount>1057335</Amount>
      </SupportedOrgInformation>
      <SupportedOrgInformation>
        <Name>
          <BusinessNameLine1>WOMEN'S DIAGNOSTIC CENTER OF BETHESDA INC</BusinessNameLine1>
        </Name>
        <EIN>592771779</EIN>
        <TypeOfOrganization>9</TypeOfOrganization>
        <ListedInGoverningDoc>true</ListedInGoverningDoc>
        <SupportedOrganizationNotified>true</SupportedOrganizationNotified>
        <OrganizedInUS>true</OrganizedInUS>
        <Amount>582860</Amount>
      </SupportedOrgInformation>
      <SupportedOrgInformation>
        <Name>
          <BusinessNameLine1>BETHESDA MEDICAL ASSOCIATES INC</BusinessNameLine1>
        </Name>
        <EIN>650561267</EIN>
        <TypeOfOrganization>3</TypeOfOrganization>
        <ListedInGoverningDoc>true</ListedInGoverningDoc>
        <SupportedOrganizationNotified>true</SupportedOrganizationNotified>
        <OrganizedInUS>true</OrganizedInUS>
        <Amount>2423070</Amount>
      </SupportedOrgInformation>
      <TotalNumberOfSupportedOrgs>4</TotalNumberOfSupportedOrgs>
      <SumOfAmounts>14129125</SumOfAmounts>
    </IRS990ScheduleA>
    <IRS990ScheduleC documentId="IRS990ScheduleC" softwareId="10000128" softwareVersion="v2010.1.0">
      <Volunteers>false</Volunteers>
      <PaidStaffOrManagement>false</PaidStaffOrManagement>
      <MediaAdvertisements>false</MediaAdvertisements>
      <MailingsMembers>false</MailingsMembers>
      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>false</GrantsOtherOrganizations>
      <DirectContactLegislators>false</DirectContactLegislators>
      <RalliesDemonstrations>false</RalliesDemonstrations>
      <OtherActivities>true</OtherActivities>
      <OtherActivitiesAmount>270355</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>270355</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>false</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>Description of other lobbying activities</Identifier>
        <ReturnReference>Schedule C, Part II-B, Line 1i</ReturnReference>
      </Form990ScheduleCPartIV>
      <Form990ScheduleCPartIV>
        <Identifier>LOBBYING</Identifier>
        <ReturnReference>SCHEDULE C, PART II-B</ReturnReference>
        <Explanation>BETHESDA HEALTHCARE SYSTEM, INC. HIRED CONSULTANTS TO LOBBY ON THEIR BEHALF REGARDING REGULATORY ISSUES PERTAINING TO MEDICAID REIMBURSEMENT, HOSPITAL EXPANSION, MALPRACTICE LIABILITY INSURANCE, AGENCY AND REGULATORY REPRESENTATION.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="10000128" softwareVersion="v2010.1.0">
      <CurrentYear>
        <BeginningOfYearBalance>17333861</BeginningOfYearBalance>
        <Contributions>6000</Contributions>
        <InvestmentEarningsOrLosses>-205068</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>0</GrantsOrScholarships>
        <OtherExpenditures>151760</OtherExpenditures>
        <AdministrativeExpenses>40082</AdministrativeExpenses>
        <EndOfYearBalance>16942951</EndOfYearBalance>
      </CurrentYear>
      <CurrentYearMinus1Year>
        <BeginningOfYearBalance>15480219</BeginningOfYearBalance>
        <Contributions>666556</Contributions>
        <InvestmentEarningsOrLosses>1518235</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>0</GrantsOrScholarships>
        <OtherExpenditures>250000</OtherExpenditures>
        <AdministrativeExpenses>81149</AdministrativeExpenses>
        <EndOfYearBalance>17333861</EndOfYearBalance>
      </CurrentYearMinus1Year>
      <CurrentYearMinus2Years>
        <BeginningOfYearBalance>15459550</BeginningOfYearBalance>
        <Contributions>60000</Contributions>
        <InvestmentEarningsOrLosses>292425</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>0</GrantsOrScholarships>
        <OtherExpenditures>250000</OtherExpenditures>
        <AdministrativeExpenses>81756</AdministrativeExpenses>
        <EndOfYearBalance>15480219</EndOfYearBalance>
      </CurrentYearMinus2Years>
      <BoardDesignatedEOYBalance>0.64030</BoardDesignatedEOYBalance>
      <PermanentEndowmentEOYBalance>0.35970</PermanentEndowmentEOYBalance>
      <TermEndowmentEOYBalance>0.00000</TermEndowmentEOYBalance>
      <EndowmentsHeldByUnrelatedOrgs>false</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>true</EndowmentsHeldByRelatedOrgs>
      <AreRelatedOrgsListedScheduleR>true</AreRelatedOrgsListedScheduleR>
      <Land>
        <OtherCostOrOtherBasis>16739571</OtherCostOrOtherBasis>
        <BookValue>16739571</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>5058502</OtherCostOrOtherBasis>
        <Depreciation>2623485</Depreciation>
        <BookValue>2435017</BookValue>
      </Buildings>
      <LeaseholdImprovements>
        <OtherCostOrOtherBasis>147888</OtherCostOrOtherBasis>
        <Depreciation>81125</Depreciation>
        <BookValue>66763</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <OtherCostOrOtherBasis>1124750</OtherCostOrOtherBasis>
        <Depreciation>1072750</Depreciation>
        <BookValue>52000</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>74065072</OtherCostOrOtherBasis>
        <BookValue>74065072</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>93358423</TotalOfBookValueLandBuildings>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>ADVANCES FROM AFFILIATES</Description>
        <Amount>3584671</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>SECURITY DEPOSITS</Description>
        <Amount>8851</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>INTEREST RATE SWAP</Description>
        <Amount>9667053</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN LIABILITY</Description>
        <Amount>617688</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>13878263</TotalOfAmounts>
      <TotalRevenue>21809586</TotalRevenue>
      <TotalExpenses>21169409</TotalExpenses>
      <ExcessOrDeficitForYear>640177</ExcessOrDeficitForYear>
      <NetUnrealizedGLOnInvestments>-7290259</NetUnrealizedGLOnInvestments>
      <OtherAmount>366972</OtherAmount>
      <TotalAdjustments>-6923287</TotalAdjustments>
      <ExcessOrDeficitPerFS>-6283110</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>15437672</TotRevenueEtcAuditedFinclStmt>
      <NetUnrealizedGainsInvestments>-7290259</NetUnrealizedGainsInvestments>
      <OtherRevenues>366972</OtherRevenues>
      <RevenueNotRptdF990>-6923287</RevenueNotRptdF990>
      <RevenueSubtotal>22360959</RevenueSubtotal>
      <OtherRevenuesNotIncluded>-1080126</OtherRevenuesNotIncluded>
      <RevenueNotRptdOnFinStmt>-1080126</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>21280833</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>21720782</TotExpensesEtcAuditedFinclStmt>
      <OtherExpensesIncluded>0</OtherExpensesIncluded>
      <ExpensesNotRptdF990>0</ExpensesNotRptdF990>
      <ExpensesSubtotal>21720782</ExpensesSubtotal>
      <OtherExpensesNotIncluded>-1080126</OtherExpensesNotIncluded>
      <ExpensesNotRptdOnFinStmt>-1080126</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>20640656</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIV>
        <Identifier>Intended uses of endowment funds</Identifier>
        <ReturnReference>Schedule D, Part V, Line 4</ReturnReference>
        <Explanation>THE ENDOWMENT FUNDS ARE HELD BY BETHESDA HOSPITAL FOUNDATION, INC. THE ENDOWMENT FUNDS ARE USED TO SUPPORT BETHESDA HEALTH SYSTEM IN THE PROVISION OF QUALITY HEALTH CARE SERVICES TO THE SURROUNDING COMMUNITY.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>FIN 48 (ASC 740) footnote</Identifier>
        <ReturnReference>Schedule D, Part X, Line 2</ReturnReference>
        <Explanation>BETHESDA HEALTHCARE SYSTEM, INC. IS INCLUDED IN CONSOLIDATED FINANCIAL STATEMENTS. BELOW IS THE FOOTNOTE INCLUDED IN THOSE FINANCIAL STATEMENTS: "THE INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT BHS, BPS, BHC, BMA, WDC, THE FOUNDATION, AND THE HOSPITAL ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). ALL OTHER AFFILIATES OF BHS ARE FOR-PROFIT ENTITIES THAT FILE A CONSOLIDATED TAX RETURN. AS OF SEPTEMBER 30, 2011 AND 2010, THE CONSOLIDATED FOR-PROFIT ENTITIES HAVE RECORDED A PROVISION FOR INCOME TAX IN ACCORDANCE WITH ASC TOPIC 740, INCOME TAXES (FORMERLY SFAS NO. 109, ACCOUNTING FOR INCOME TAXES). THE SYSTEM APPLIES THE PROVISIONS OF ASC TOPIC 740, INCOME TAXES (FORMERLY FASB INTERPRETATION NO.(FIN) 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF FASB STATEMENT NO. 109, ACCOUNTING FOR INCOME TAXES). THIS GUIDANCE CREATES A SINGLE MODEL TO ADDRESS UNCERTAIN INCOME TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MORE-LIKELY-THAN-NOT MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF ASC TOPIC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS A RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS."</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="IRS990ScheduleI" softwareId="10000128" softwareVersion="v2010.1.0">
      <RecordsMaintained>true</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>AMERICAN HEART ASSOCIATION</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO BOX 4002900</AddressLine1>
          <City>DES MOINES</City>
          <State>IA</State>
          <ZIPCode>503402900</ZIPCode>
        </AddressUS>
        <EINOfRecipient>135613797</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>7500</AmountOfCashGrant>
        <PurposeOfGrant>ORGANIZATIONAL SUPPORT</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>DEVOS-BLUM FAMILY YMCA</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>9600 SOUTH MILITARY TRAIL</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33436</ZIPCode>
        </AddressUS>
        <EINOfRecipient>591416281</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>10000</AmountOfCashGrant>
        <PurposeOfGrant>ORGANIZATIONAL SUPPORT</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>GREATER BOYNTON BEACH CHAMBER OF COMMERCE</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1880 NORTH CONGRESS AVENUE</AddressLine1>
          <AddressLine2>SUITE 106</AddressLine2>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33426</ZIPCode>
        </AddressUS>
        <EINOfRecipient>591304441</EINOfRecipient>
        <IRCSection>501(C)(6)</IRCSection>
        <AmountOfCashGrant>9050</AmountOfCashGrant>
        <PurposeOfGrant>ORGANIZATIONAL SUPPORT</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>PALM BEACH COUNTY MEDICAL SOCIETY</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>3540 FOREST HILL BLVD</AddressLine1>
          <City>WEST PALM BEACH</City>
          <State>FL</State>
          <ZIPCode>33406</ZIPCode>
        </AddressUS>
        <EINOfRecipient>300130804</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>10000</AmountOfCashGrant>
        <PurposeOfGrant>ORGANIZATIONAL SUPPORT</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>SUSAN G KOMEN SOUTH FLORIDA RACE FOR THE CURE</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1309 NORTH FLAGLER DRIVE</AddressLine1>
          <AddressLine2>5TH FLOOR</AddressLine2>
          <City>WEST PALM BEACH</City>
          <State>FL</State>
          <ZIPCode>33401</ZIPCode>
        </AddressUS>
        <EINOfRecipient>650254225</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>25000</AmountOfCashGrant>
        <PurposeOfGrant>ORGANIZATIONAL SUPPORT</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>4</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>1</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIV>
        <Identifier>Procedures for monitoring use of grant funds</Identifier>
        <ReturnReference>Schedule I, Part I, Line 2</ReturnReference>
        <Explanation>THE SYSTEM MAKES GRANTS TO ORGANIZATIONS BASED ON REVIEW AND INTENT OF THE USE OF THE FUNDS IS AND CONSISTENT WITH THE EXEMPT PURPOSE OF THE GRANTEE ORGANIZATION(S).</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="10000128" softwareVersion="v2010.1.0">
      <IdemnificationGrossUpPayments>X</IdemnificationGrossUpPayments>
      <ClubDuesOrFees>X</ClubDuesOrFees>
      <WrittenPolicyReTAndEExpenses>true</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>true</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <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>ROBERT B HILL</NamePerson>
        <BaseCompensationFilingOrg>455968</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>107597</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>312846</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>80288</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>5312</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>962011</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ROGER L KIRK</NamePerson>
        <BaseCompensationFilingOrg>306176</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>46222</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>23344</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>55794</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>15670</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>447206</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JOANNE AQUILINA</NamePerson>
        <BaseCompensationFilingOrg>196150</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>29163</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>21561</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>13264</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>31638</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>291776</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ROBERT BROADWAY</NamePerson>
        <BaseCompensationFilingOrg>172649</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>27183</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>3387</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>29893</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>19977</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>253089</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>REGINA CRAFA</NamePerson>
        <BaseCompensationFilingOrg>148357</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>25217</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>8670</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>13876</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>11452</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>207572</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MICHAEL BROWN</NamePerson>
        <BaseCompensationFilingOrg>116043</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>20847</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>1434</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>19116</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>5385</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>162825</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>LESLIE DURHAM</NamePerson>
        <BaseCompensationFilingOrg>117632</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>20105</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>3840</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>28973</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>12221</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>182771</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>GARY RITSON</NamePerson>
        <BaseCompensationFilingOrg>99500</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>17237</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>3777</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>20282</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>16425</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>157221</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>Tax indemnification and gross-up payments</Identifier>
        <ReturnReference>Schedule J, Part I, Line 1a</ReturnReference>
        <Explanation>ROBERT HILL, ROGER KIRK AND ROBERT BROADWAY RECEIVE GROSS-UP PAYMENTS RELATED TO THE GOLF CLUB MEMBERSHIPS. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION TO THESE INTERESTED PERSONS.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Health or social club dues or initiation fees</Identifier>
        <ReturnReference>Schedule J, Part I, Line 1a</ReturnReference>
        <Explanation>ROBERT HILL, ROGER KIRK AND ROBERT BROADWAY ARE REIMBURSED FOR GOLF CLUB MEMBERSHIPS. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION TO THESE INTERESTED PERSONS.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Supplemental nonqualified retirement plan</Identifier>
        <ReturnReference>Schedule J, Part I, Line 4b</ReturnReference>
        <Explanation>PAYMENTS RECEIVED FROM THE PLAN FOR THE FOLLOWING: ROBERT B. HILL $272,845 JOANNE AQUILINA $20,826 ROBERT BROADWAY $507 REGINA CRAFA $8.110 GARY RITSON $146 CONTRIBUTIONS INTO THE PLAN FOR THE FOLLOWING: ROGER L. KIRK $20,821 ROBERT BROADWAY $2,308 REGINA CRAFA $5,479 LESLIE DURHAM $7,683 GARY RITSON $4,229</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK1" softwareId="10000128" softwareVersion="v2010.1.0">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>PALM BEACH COUNTY HEALTH FACILITIES AUTHORITY</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>521297506</IssuerEIN>
        <CUSIPNumber>69650QAM2</CUSIPNumber>
        <DateIssued>2010-04-22</DateIssued>
        <IssuePrice>128183549</IssuePrice>
        <DescriptionOfPurpose>SEE SCHEDULE O - SERIES 2010A</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>PALM BEACH COUNTY HEALTH FACILITIES AUTHORITY</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>521297506</IssuerEIN>
        <DateIssued>2010-04-23</DateIssued>
        <IssuePrice>85000000</IssuePrice>
        <DescriptionOfPurpose>SEE SCHEDULE O - SERIES 2010B</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>0</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>128380777</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>2534213</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>1804473</IssuanceCostsFromProceeds>
        <CreditEnhancement>3156855</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>33742719</CapitalExpenditures>
        <OtherSpentProceeds>82927356</OtherSpentProceeds>
        <AmountUnspent>4215161</AmountUnspent>
        <YearOfSubstCompletion>2013</YearOfSubstCompletion>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>false</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <AmountRetired>0</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>85000000</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>941186</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>15981480</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>68077334</AmountUnspent>
        <YearOfSubstCompletion>2013</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>false</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>true</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>false</BondCounselRoutinelyEngaged>
        <PrcntgePrvtBusinessUseByOthers>0.0018</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.0000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.0018</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>false</BondCounselRoutinelyEngaged>
        <PrcntgePrvtBusinessUseByOthers>0.0000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.0000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.0000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <TermOfHedge>0.0</TermOfHedge>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <TermOfGIC>0.0</TermOfGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>true</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>true</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <TermOfHedge>0.0</TermOfHedge>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <TermOfGIC>0.0</TermOfGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>true</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartV>
        <Identifier>DESCRIPTION OF PURPOSE</Identifier>
        <ReturnReference>SCHEDULE K, PART I, COLUMN (F)</ReturnReference>
        <Explanation>PALM BEACH COUNTY HEALTH FACILITIES AUTHORITY HEALTH FACILITIES REVENUE BONDS - SERIES 2010A ISSUED (A) TO REFUND 3 BONDS ISSUES ISSUED ON 12/20/2001, 8/14/2003, AND 3/23/2006 (B) TO FINANCE THE CONSTRUCTION OF A NEW HOSPITAL. PALM BEACH COUNTY HEALTH FACILITIES AUTHORITY HEALTH FACILITIES REVENUE BONDS - SERIES 2010B ISSUED TO FINANCE THE CONSTRUCTION OF A NEW HOSPITAL.</Explanation>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <Identifier>TOTAL PROCEEDS OF ISSUE</Identifier>
        <ReturnReference>PART II, LINE 3</ReturnReference>
        <Explanation>TOTAL PROCEEDS OF ISSUE IS NOT IDENTICAL TO ISSUE PRICE DUE TO INTEREST INCOME OF $833,286 OFFSET BY NET REALIZED LOSSES OF $636,058.</Explanation>
      </Form990ScheduleKPartV>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="10000128" softwareVersion="v2010.1.0">
      <GeneralExplanation>
        <Identifier>Review of form 990 by governing body</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 11a</ReturnReference>
        <Explanation>THE CHIEF FINANCIAL OFFICER OF THE ORGANIZATION REVIEWS THE FORM 990 AND ALL REQUIRED SUPPORTING SCHEDULES. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF TRUSTEES OF THE ORGANIZATION FOR REVIEW PRIOR TO FILING WITH THE IRS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Conflict of interest policy</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 12c</ReturnReference>
        <Explanation>THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ANY TRUSTEE, DIRECTOR, PRINCIPAL OFFICER OR MEMBER OF ANY COMMITTEE OF THE BOARD WITH BOARD-DELEGATED POWERS. THE INDIVIDUALS COVERED UNDER THE POLICY ARE REQUIRED TO DISCLOSE ANNUALLY ANY CONFLICTS OF INTEREST. THE CHAIRMAN OF THE BOARD AND THE INTERNAL AUDIT DIVISION OF BETHESDA HEALTHCARE SYSTEM CONTINUOUSLY REVIEW AND MONITOR ALL CONFLICTS OF INTEREST NOTED BY THE INDIVIDUALS COVERED UNDER THE POLICY. ANY INDIVIDUAL WHO HAS A CONFLICT OF INTEREST IS PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISION IN THE TRANSACTION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Process used to establish compensation of top management official</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 15a</ReturnReference>
        <Explanation>THE BOARD OF TRUSTEES OF BETHESDA HEALTHCARE SYSTEM ANNUALLY APPOINTS THE PRESIDENT/CEO OF BETHESDA HEALTHCARE SYSTEM TO A ONE-YEAR TERM AND ESTABLISHES AND APPROVES THE COMPENSATION OF THE PRESIDENT/CEO. THE BOARD OF TRUSTEES OF BETHESDA HEALTHCARE SYSTEM PERIODICALLY ENGAGES AN INDEPENDENT OUTSIDE PROFESSIONAL COMPENSATION FIRM TO REVIEW COMPENSATION AND BENEFIT LEVELS OF THE PRESIDENT AND CHIEF FINANCIAL OFFICER OF THE BETHESDA HEALTHCARE SYSTEM. THE CONSULTING FIRM WORKS INDEPENDENTLY OF MANAGEMENT AND REPORTS THE INFORMATION DIRECTLY TO THE TRUSTEES OF BETHESDA HEALTHCARE SYSTEM FOR THE OFFICER'S POSITIONS. THE CONSULTING FIRM PROVIDES DETAILED COMPENSATION AND BENEFIT DATA FOR COMPARABLY SIZED HEALTHCARE ORGANIZATIONS ON A REGIONAL AND NATIONAL BASIS. BASED ON THE COMPENSATION PHILOSOPHY OF THE BOARD OF TRUSTEES OF THE BETHESDA HEALTHCARE SYSTEM AS IT RELATES TO THE MARKET IN GENERAL AND ON SPECIFIC COMPENSATION LEVELS NOTED AS THE RESULT OF THE CONSULTING ENGAGEMENT, THE BOARD OF TRUSTEES OF BETHESDA HEALTHCARE SYSTEM SETS THE COMPENSATION AND BENEFITS OF THE POSITIONS NOTED ABOVE. THE PROCESS WAS UNDERTAKEN IN THE YEAR ENDED SEPTEMBER 30, 2011. THE PROCESS AND DECISIONS ARE DOCUMENTED IN THE BOARD MINUTES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Process used to establish compensation of other officers/key employees</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 15b</ReturnReference>
        <Explanation>THE OTHER OFFICERS OF THE ORGANIZATION ARE SUBJECT TO BETHESDA HEALTHCARE SYSTEMS' ANNUAL EMPLOYEE REVIEW PROCESS. THE VICE PRESIDENT OF HUMAN RESOURCES RECOMMENDS TO THE PRESIDENT/CEO OF THE BETHESDA HEALTHCARE SYSTEM, INC. COMPENSATION AND BENEFIT LEVELS. THE VICE PRESIDENT OF HUMAN RESOURCES PERIODICALLY ENGAGES AN INDEPENDENT OUTSIDE PROFESSIONAL COMPENSATION FIRM TO REVIEW COMPENSATION AND BENEFIT LEVELS OF THIS AND OTHER MANAGEMENT LEVEL POSITIONS. THE CONSULTING FIRM WORKS INDEPENDENTLY OF MANAGEMENT AND PROVIDES DETAILED COMPENSATION AND BENEFIT DATA FOR COMPARABLY SIZED HEALTHCARE ORGANIZATIONS ON A REGIONAL AND NATIONAL BASIS. BASED ON THE COMPENSATION PHILOSOPHY OF THE BOARD OF TRUSTEES OF THE BETHESDA HEALTHCARE SYSTEM AS IT RELATES TO THE MARKET IN GENERAL AND ON SPECIFIC COMPENSATION LEVELS NOTED AS THE RESULT OF THE CONSULTING ENGAGEMENT, THE PRESIDENT/CEO OF BETHESDA HEALTHCARE SYSTEM SETS THE COMPENSATION AND BENEFITS FOR THE OTHER OFFICERS. THE PROCESS WAS UNDERTAKEN FOR THE YEAR ENDED SEPTEMBER 30, 2011. THE PROCESS AND DECISIONS ARE DOCUMENTED IN THE EMPLOYEE FILES. THE COMPENSATION OF THE CHIEF FINANCIAL OFFICER IS DETERMINED BY THE BOARD OF TRUSTEES OF BETHESDA HEALTHCARE SYSTEM AS DESCRIBED IN THE NARRATIVE FOR FORM 990, PART VI, LINE 15A.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Public Disclosure</Identifier>
        <ReturnReference>Form 990, Part VI, Section C, Line 19</ReturnReference>
        <Explanation>THE GOVERNING DOCUMENTS OF THE ORGANIZATION, ITS CONFLICT OF INTEREST POLICY, ITS FINANCIAL STATEMENTS ARE AVAILABLE ON REQUEST. DEPENDING ON THE QUANTITY OF THE REQUEST A MINIMAL FEE MAY APPLY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS WORKED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990, PART VII, SECTION A, COLUMN B</ReturnReference>
        <Explanation>IN ADDITION TO TIME SPENT AT BETHESDA HEALTHCARE SYSTEM, INC. THE OFFICERS ALSO DEVOTE TIME TO THE OTHER RELATED ORGANIZATIONS. BELOW ARE THE OTHER ORGANIZATIONS IN WHICH THEY DEVOTE TIME. BETHESDA MEMORIAL HOSPITAL ROBERT B. HILL - 2 HOURS/WEEK ROGER L. KIRK - 2 HOURS/WEEK JOANNE AQUILINA- 2 HOURS/WEEK BETHESDA HEALTH CITY ROBERT B. HILL - 2 HOURS/WEEK ROGER L. KIRK - 2 HOURS/WEEK JOANNE AQUILINA- 2 HOURS/WEEK ROBERT L. BROADWAY - 2 HOURS/WEEK BETHESDA HOSPITAL FOUNDATION ROBERT B. HILL - 2 HOURS/WEEK ROGER L. KIRK - 2 HOURS/WEEK JOANNE AQUILINA- 2 HOURS/WEEK ROBERT L. BROADWAY - 2 HOURS/WEEK BETHESDA MEMORIAL SELF INSURANCE MALPRACTICE ROBERT B. HILL - 2 HOURS/WEEK BETHESDA MEMORIAL SELF INSURANCE WORKMAN'S COMP ROBERT B. HILL - 2 HOURS/WEEK BETHESDA PAYROLL SERVICES ROBERT B. HILL - 2 HOURS/WEEK ROGER L. KIRK - 2 HOURS/WEEK JOANNE AQUILINA- 2 HOURS/WEEK ROBERT L. BROADWAY - 2 HOURS/WEEK WOMEN'S DIAGNOTIC CENTER OF BETHESDA ROBERT B. HILL - 2 HOURS/WEEK ROGER L. KIRK - 2 HOURS/WEEK JOANNE AQUILINA- 2 HOURS/WEEK ROBERT L. BROADWAY - 2 HOURS/WEEK BETHESDA MEDICAL ASSOCIATES ROBERT B. HILL - 2 HOURS/WEEK ROGER L. KIRK - 2 HOURS/WEEK JOANNE AQUILINA- 2 HOURS/WEEK ROBERT L. BROADWAY - 2 HOURS/WEEK</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Other changes in net assets or fund balances</Identifier>
        <ReturnReference>Form 990, Part XI, Line 5</ReturnReference>
        <Explanation>NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - -7290259; CHANGE IN INVESTMENT IN AFFILIATES - 366973; TRANSFER TO AFFILIATES - 11878207;</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="10000128" softwareVersion="v2010.1.0">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BETHESDA MEMORIAL HOSPITAL INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>592447554</EIN>
        <PrimaryActivities>HOSPITAL</PrimaryActivities>
        <LegalDomicileState>FL</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BETHESDA HEALTH CITY INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>650561263</EIN>
        <PrimaryActivities>O/P MED SVCS</PrimaryActivities>
        <LegalDomicileState>FL</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>WOMEN''S DIAGNOSTIC CENTER OF BETHESDA INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>592771779</EIN>
        <PrimaryActivities>O/P MED SVCS</PrimaryActivities>
        <LegalDomicileState>FL</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BETHESDA HOSPITAL FOUNDATION INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>596137805</EIN>
        <PrimaryActivities>FUNDRAISING</PrimaryActivities>
        <LegalDomicileState>FL</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BETHESDA MEMORIAL SIT - WORKMAN'S COMP</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>596775830</EIN>
        <PrimaryActivities>SELF INS TRUST</PrimaryActivities>
        <LegalDomicileState>FL</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11 - Type I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BETHESDA MEMORIAL SIT - MALPRACTICE</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>592230109</EIN>
        <PrimaryActivities>SELF INS TRUST</PrimaryActivities>
        <LegalDomicileState>FL</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11 - Type I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BETHESDA PAYROLL SERVICES INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>650523164</EIN>
        <PrimaryActivities>PAYROLL SUPPORT</PrimaryActivities>
        <LegalDomicileState>FL</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11 - Type III - FI</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>BETHESDA MEDICAL ASSOCIATES INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>650561267</EIN>
        <PrimaryActivities>O/P MED SVCS</PrimaryActivities>
        <LegalDomicileState>FL</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>CARE SVCS BETHESDA</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>201745631</EIN>
        <PrimaryActivity>MEDICARE HOME HEALTH</PrimaryActivity>
        <LegalDomicileState>FL</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>BETHESDA HOLDING COMPANY INC AND SUBS</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>2815 S SEACREST BLVD</AddressLine1>
          <City>BOYNTON BEACH</City>
          <State>FL</State>
          <ZIPCode>33435</ZIPCode>
        </AddressUS>
        <EIN>592663767</EIN>
        <PrimaryActivity>HOLDING CO</PrimaryActivity>
        <LegalDomicileState>FL</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>BHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>2881943</ShareOfTotalIncome>
        <ShareOfEOYAssets>1330879</ShareOfEOYAssets>
        <PercentageOwnership>1</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>true</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>true</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>true</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA HEALTH CITY</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>P</TransactionType>
        <AmountInvolved>1721638</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA HEALTH CITY</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>1069335</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA HEALTH CITY</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>78830</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA MEDICAL ASSOCIATES</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>2423070</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA MEDICAL ASSOCIATES</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>P</TransactionType>
        <AmountInvolved>11223178</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>WOMENS DIAGNOSTIC CENTER OF BETHESDA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>582860</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>WOMENS DIAGNOSTIC CENTER OF BETHESDA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>P</TransactionType>
        <AmountInvolved>1387294</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA PAYROLL SERVICES</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>P</TransactionType>
        <AmountInvolved>4623550</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA PAYROLL SERVICES</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>10826891</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA HOLDING COMPANY</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>A</TransactionType>
        <AmountInvolved>148698</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA HOLDING COMPANY</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>490818</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA HOLDING COMPANY</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>P</TransactionType>
        <AmountInvolved>871578</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA MEMORIAL HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>10065860</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA MEMORIAL HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>4372652</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA MEMORIAL HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>R</TransactionType>
        <AmountInvolved>5060575</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA MEMORIAL HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>I</TransactionType>
        <AmountInvolved>286780</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA MEMORIAL HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>P</TransactionType>
        <AmountInvolved>124007459</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>BETHESDA MEMORIAL HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>314993</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>