<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2020v4.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2021-11-12T06:57:07-06:00</ReturnTs>
    <TaxPeriodEndDt>2020-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>561315966</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>NUNN BRASHEAR &amp; UZZELL PA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>PO BOX 10127</AddressLine1Txt>
        <CityNm>GOLDSBORO</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>27532</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2020-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>561209062</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>GOSHEN MEDICAL CENTER INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>GOSH</BusinessNameControlTxt>
      <PhoneNum>9102671942</PhoneNum>
      <USAddress>
        <AddressLine1Txt>PO BOX 187</AddressLine1Txt>
        <CityNm>FAISON</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>283410187</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>GREGORY M BOUNDS</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <PhoneNum>9102678692</PhoneNum>
      <SignatureDt>2021-11-11</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>GREGORY</PersonFirstNm>
        <PersonLastNm>BOUNDS</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>HAROLD D BRASHEAR CPA</PreparerPersonNm>
      <PTIN>P00103968</PTIN>
      <PhoneNum>9197781000</PhoneNum>
      <PreparationDt>2021-11-11</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2020</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc5">
      <PrincipalOfficerNm>CHESTER AYCOCK</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>PO BOX 187</AddressLine1Txt>
        <CityNm>FAISON</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>28341</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>56212509</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.GOSHENMEDICAL.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1979</FormationYr>
      <LegalDomicileStateCd>NC</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROVIDE MEDICAL CARE TO INDIGENT INDIVIDUALS IN UNDERSERVED RURAL AREAS IN NORTH CAROLINA.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>9</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>461</TotalEmployeeCnt>
      <TotalVolunteersCnt>10</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>10480198</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>20611780</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>22292626</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>34190583</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>7970</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>3592</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>791193</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>1406554</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>33571987</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>56212509</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>20806655</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>23928982</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>11339686</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>20027561</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>32146341</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>43956543</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>1425646</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>12255966</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>28502028</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>42237358</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>6789362</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>8268726</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>21712666</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>33968632</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>TO PROVIDE MEDICAL CARE TO INDIGENT INDIVIDUALS IN UNDERSERVED RURAL AREAS IN NORTH CAROLINA.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>35948917</ExpenseAmt>
      <Desc>GOSHEN MEDICAL CENTER, INC. IS A MEDICAL CLINIC ORGANIZED TO PROVIDE MEDICAL SERVICES TO UNDERSERVED AREAS IN EASTERN NORTH CAROLINA. THESE SERVICES INCLUDE MIGRANT HEALTH AND DENTAL CARE. FEES ARE ADJUSTED FOR THOSE WHO ARE EITHER UN- INSURED OR UNDER-INSURED.</Desc>
      <TotalProgramServiceExpensesAmt>35948917</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc6">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc3">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc3">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc3">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc3">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc3">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc3">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc3">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc3">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc3">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc3">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc3">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc3">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc3">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc4">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>74</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>461</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>9</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>GREG BOUNDS</PersonNm>
        <PhoneNum>9102679997</PhoneNum>
        <USAddress>
          <AddressLine1Txt>412 SW CENTER ST</AddressLine1Txt>
          <CityNm>FAISON</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>28341</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY M BOUNDS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>448576</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32946</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS MAYNOR</PersonNm>
        <TitleTxt>CHIEF MED. O</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>323087</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32949</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AIXA N KIMES</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>318940</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>1302</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PEGGY BARNHILL</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>293565</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19946</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EARLIE JOHNSON JR</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>199430</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14992</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FRANQUIL DIAZ</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>178900</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26460</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTIE ATKINSON</PersonNm>
        <TitleTxt>CO-CHAIRMAN</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHESTER AYCOCK</PersonNm>
        <TitleTxt>BD CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MILLIE BLAND</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATRICIA DAVIS</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TANTY FREEMAN</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHARLOTTE GRAHAM</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARGARET JACKSON</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES ROA</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EDITH DE SOSA</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1762498</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>128595</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>6</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NAIA CORPORATION</BusinessNameLine1Txt>
            <BusinessNameLine2Txt>NAIA CORPORATION</BusinessNameLine2Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2160 HIGHLAND AVE S STE 100-156</AddressLine1Txt>
            <AddressLine2Txt>2160 HIGHLAND AVE S STE 100-156</AddressLine2Txt>
            <CityNm>BIRMINGHAM</CityNm>
            <StateAbbreviationCd>AL</StateAbbreviationCd>
            <ZIPCd>35205</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT SERVICE</ServicesDesc>
        <CompensationAmt>1112364</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PRACTICE MGT SUPPORT SERVICES INC</BusinessNameLine1Txt>
            <BusinessNameLine2Txt>PRACTICE MGT SUPPORT SERVICES INC</BusinessNameLine2Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>300 N MARTINGALE RD STE 150</AddressLine1Txt>
            <AddressLine2Txt>300 N MARTINGALE RD STE 150</AddressLine2Txt>
            <CityNm>SCHAUMBURG</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60173</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL BILLING</ServicesDesc>
        <CompensationAmt>902472</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TINKBIRD HEALTHCARE STAFFING</BusinessNameLine1Txt>
            <BusinessNameLine2Txt>TINKBIRD HEALTHCARE STAFFING</BusinessNameLine2Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 17091</AddressLine1Txt>
            <AddressLine2Txt>PO BOX 17091</AddressLine2Txt>
            <CityNm>RALEIGH</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27619</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LOCUM DOCTORS</ServicesDesc>
        <CompensationAmt>453106</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TERRY MAXTON HOLLOMAN</BusinessNameLine1Txt>
            <BusinessNameLine2Txt>TERRY MAXTON HOLLOMAN</BusinessNameLine2Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>210 DEEN ST</AddressLine1Txt>
            <AddressLine2Txt>210 DEEN ST</AddressLine2Txt>
            <CityNm>MOUNT OLIVE</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>28365</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>BLDG CONTRACTOR</ServicesDesc>
        <CompensationAmt>404207</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SC TELECOMMUNICATIONS GROUP HOLDINGS</BusinessNameLine1Txt>
            <BusinessNameLine2Txt>SC TELECOMMUNICATIONS GROUP HOLDINGS</BusinessNameLine2Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 603030</AddressLine1Txt>
            <AddressLine2Txt>PO BOX 603030</AddressLine2Txt>
            <CityNm>CHARLOTTE</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>28260</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT SERVICES</ServicesDesc>
        <CompensationAmt>301436</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>10</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>20611780</GovernmentGrantsAmt>
      <NoncashContributionsAmt>10283</NoncashContributionsAmt>
      <TotalContributionsAmt>20611780</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT FEES, NET OF ADJ.</Desc>
        <TotalRevenueColumnAmt>56477949</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>56477949</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>340B-PHARMACY</Desc>
        <TotalRevenueColumnAmt>5642513</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5642513</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MISCELLANEOUS OFFICE SPACE</Desc>
        <TotalRevenueColumnAmt>8950</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8950</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CHARITY CARE ADJUSTMENTS</Desc>
        <TotalRevenueColumnAmt>-3228143</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-3228143</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACTUAL ADJUSTMENTS</Desc>
        <TotalRevenueColumnAmt>-24710686</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-24710686</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>34190583</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>3592</TotalRevenueColumnAmt>
        <ExclusionAmt>3592</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAROLINA ACCESS INCOME</Desc>
        <TotalRevenueColumnAmt>1042530</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1042530</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>INCENTIVES</Desc>
        <TotalRevenueColumnAmt>300741</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>300741</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>SALE OF ASSET</Desc>
        <TotalRevenueColumnAmt>53546</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>53546</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>9737</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9737</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>1406554</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>56212509</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>35597137</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>3592</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>481522</TotalAmt>
        <ManagementAndGeneralAmt>481522</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>18248159</TotalAmt>
        <ProgramServicesAmt>15418396</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2829763</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>778801</TotalAmt>
        <ProgramServicesAmt>557715</ProgramServicesAmt>
        <ManagementAndGeneralAmt>221086</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3201528</TotalAmt>
        <ProgramServicesAmt>2627390</ProgramServicesAmt>
        <ManagementAndGeneralAmt>574138</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1218972</TotalAmt>
        <ProgramServicesAmt>1033933</ProgramServicesAmt>
        <ManagementAndGeneralAmt>185039</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>204674</TotalAmt>
        <ManagementAndGeneralAmt>204674</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>75648</TotalAmt>
        <ManagementAndGeneralAmt>75648</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2903171</TotalAmt>
        <ProgramServicesAmt>934983</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1968188</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>475</TotalAmt>
        <ManagementAndGeneralAmt>475</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>3957622</TotalAmt>
        <ProgramServicesAmt>3581898</ProgramServicesAmt>
        <ManagementAndGeneralAmt>375724</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>3179670</TotalAmt>
        <ProgramServicesAmt>2543546</ProgramServicesAmt>
        <ManagementAndGeneralAmt>636124</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>120999</TotalAmt>
        <ProgramServicesAmt>53506</ProgramServicesAmt>
        <ManagementAndGeneralAmt>67493</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>23079</TotalAmt>
        <ProgramServicesAmt>10850</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12229</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>146604</TotalAmt>
        <ProgramServicesAmt>146604</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1111611</TotalAmt>
        <ProgramServicesAmt>992410</ProgramServicesAmt>
        <ManagementAndGeneralAmt>119201</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>254044</TotalAmt>
        <ProgramServicesAmt>9814</ProgramServicesAmt>
        <ManagementAndGeneralAmt>244230</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>UNCOLLECTIBLE ACCOUNTS</Desc>
        <TotalAmt>5110464</TotalAmt>
        <ProgramServicesAmt>5110464</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>COGS</Desc>
        <TotalAmt>2316262</TotalAmt>
        <ProgramServicesAmt>2316262</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL-DRUGS</Desc>
        <TotalAmt>592575</TotalAmt>
        <ProgramServicesAmt>592575</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FACILITY-TAXES &amp; LICENSES</Desc>
        <TotalAmt>13612</TotalAmt>
        <ProgramServicesAmt>13612</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>17051</TotalAmt>
        <ProgramServicesAmt>4959</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12092</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>43956543</TotalAmt>
        <ProgramServicesAmt>35948917</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8007626</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2755482</BOYAmt>
        <EOYAmt>3669612</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>816848</BOYAmt>
        <EOYAmt>7122414</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>379716</BOYAmt>
        <EOYAmt>1711922</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2324791</BOYAmt>
        <EOYAmt>5733436</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>338946</BOYAmt>
        <EOYAmt>855643</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <LandBldgEquipCostOrOtherBssAmt>32499129</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>11116999</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>20697819</BOYAmt>
        <EOYAmt>21382130</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>155613</BOYAmt>
        <EOYAmt>321845</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>352935</BOYAmt>
        <EOYAmt>333335</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>679878</BOYAmt>
        <EOYAmt>1107021</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>28502028</BOYAmt>
        <EOYAmt>42237358</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1820746</BOYAmt>
        <EOYAmt>2727560</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>162000</BOYAmt>
        <EOYAmt>1098330</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>4653541</BOYAmt>
        <EOYAmt>4121054</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>153075</BOYAmt>
        <EOYAmt>321782</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>6789362</BOYAmt>
        <EOYAmt>8268726</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>21712666</BOYAmt>
        <EOYAmt>33968632</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>21712666</BOYAmt>
        <EOYAmt>33968632</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>28502028</BOYAmt>
        <EOYAmt>42237358</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>12255966</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc6">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>9205072</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>10058018</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9425807</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10480198</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>20611780</CurrentTaxYearAmt>
        <TotalAmt>59780875</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>9205072</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>10058018</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9425807</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10480198</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>20611780</CurrentTaxYearAmt>
        <TotalAmt>59780875</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>59780875</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>1124</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1523</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3355</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7970</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3592</CurrentTaxYearAmt>
        <TotalAmt>17564</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>59798439</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>100685874</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.99970</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99970</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc3">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>3292061</OtherCostOrOtherBasisAmt>
        <BookValueAmt>3292061</BookValueAmt>
      </LandGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>238252</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>147857</DepreciationAmt>
        <BookValueAmt>90395</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>6801838</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>5197802</DepreciationAmt>
        <BookValueAmt>1604036</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>474289</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>254123</DepreciationAmt>
        <BookValueAmt>220166</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>5206658</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>TOP HAT 457B PLAN</Desc>
        <Amt>321782</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>321782</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>56212509</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>56212509</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>56212509</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>43956543</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>43956543</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>43956543</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc4">
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GREGORY M BOUNDS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>448576</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>31863</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>1083</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>481522</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS MAYNOR</PersonNm>
        <TitleTxt>CHIEF MED. OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>323087</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>31866</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>1083</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>356036</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AIXA N KIMES</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>85000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>233940</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>882</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>420</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>320242</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PEGGY BARNHILL</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>200000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>93565</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>18863</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>1083</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>313511</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EARLIE JOHNSON JR</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>175000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>24430</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>13909</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>1083</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>214422</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>FRANQUIL DIAZ</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>170000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>8900</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>25377</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>1083</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>205360</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 1, PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS OF GOSHEN MEDICAL CENTER, INC. SERVE ON A VOLUNTEER BASIS AND ARE NOT PAID FOR THEIR SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS ARE PRESENTED A COPY OF THE FORM 990 FOR THEIR REVIEW AT THE MONTHLY BOARD MEETING BEFORE BEING FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD MEMBER SHALL ANNOUNCE SUCH POSSIBLE CONFLICT OF INTEREST AS NOTED IN THE ORGANIZATION'S BYLAWS ARTICLE 8. CONFLICT OF INTEREST IS DISCUSSED AT BOARD MEETINGS WHEN ONE EXPRESSES THEIR OPINION OR IF VOTING IS TO OCCUR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUALLY THE BOARD OF DIRECTORS APPROVES THE CEO'S PAYRATE AND ANY BONUSES BY ANALYZING THE PERFORMANCE OF THE CENTER AND THE PERFORMANCE OF THE CEO'S DUTIES LISTED IN HIS JOB DESCRIPTION; AS REFLECTED IN SUCH OUTCOMES AND MEASURES AS THE ANNUAL AUDITS, MONTHLY FINANCIAL REPORTS, GROWTH IN ASSETS, GROWTH IN FULFILLMENT OF THE MISSION, EXPANSION OF THE MISSION THROUGH NEW SERVICES AND NEW SITES, GROWTH IN BUDGET AND OPERATIONAL RESPONSIBILITIES, PUBLIC RELATION ACTIVITIES AND COMPLIANCE WITH HRSA PROGRAM REQUIREMENTS. THE BOARD ALSO REVIEWS THE NACHC HEALTH CENTER SALARY AND BENEFITS SURVEY THAT LISTS NATIONAL DATA ON SALARIES STRATIFIED BY THE SIZE OF THE HEALTH CENTER BUDGETS. THE CEO DETERMINES THE PAY RATE FOR TOP MANAGEMENT AND KEY EMPLOYEES OF THE ORGANIZATION THROUGH ANNUAL PERFORMANCE REVIEWS OF PERSONAL DEVELOPMENT PLANS, GOAL ACCOMPLISHMENTS, AND REVIEW OF THE SALARY AND BENEFIT SURVEY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER OFFICERS AND EMPLOYEES PAY RATES ARE SET BY THE CEO AND REVIEWED BY HUMAN RESOURCES AND AN EXECUTIVE. BONUS COMPENSATION IS CALCULATED ON SALARY, TENURE, PRODUCTION, AND INDIVIDUAL RATES FROM AND APPROVED FUNDING BY THE BOARD OF DIRECTORS. THE CHIEF MEDICAL OFFICER RECEIVES AN ANNUAL RAISE AND SEMI-ANNUAL BONUS COMPARABLE TO THE CEO'S PERCENT APPROVED BY THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THESE DOCUMENTS ARE AVAILABLE FOR INSPECTION IN THE CORPORATE OFFICES UPON REQUEST OF THE CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
