Care Health S-4 Registration of securities issued in business combination transactions

Exhibit 3.243

STATE OF TENNESSEE
Tre Hargett, Secretary of State
Division of Business Services
William R. Snodgrass Tower
312 Rosa L. Parks AVE, 6th FL
Nashville, TN 37243-1102

     CFS
     992 DAVIDSON DRIVE
     SUITE B
     Nashville, TN 37205

Request Type: Certified Copies	Issuance Date: 03/11/2011
Request #: 33899	Copies Requested: 1

Document Receipt

Receipt: 376889	Filing Fee:	$	20.00
Payment-Account - CFS, NASHVILLE, TN		$	20.00

I, Tre Hargett, Secretary of State of the State of Tennessee, do hereby certify thatPHC-AVIATION, INC.,Control # 418520 was formed or qualified to do business in the State of Tennessee on 12/13/2001. PHC-AVIATION, INC. has a home jurisdiction of Williamson County and is currently in an Active status.

    Tre Hargett
Secretary of State

Processed By: Nichole Hambrick

The attached document(s) was/were filed in this office on the date(s) indicated below:

Reference #	Date Filed	Filing Description
4354-2858	12/13/2001	Initial Filing
5378-2884	03/04/2005	2004 Annual Report (Due 04/01/2005)
5507-1797	07/14/2005	Registered Agent Change (by Entity)
5727-1748	03/22/2006	2005 Annual Report (Due 04/01/2006)

Phone 615-741-6488 * Fax (615) 741-7310 * Website: http://tnbear.tn.gov/

Page 1 of 1

CHARTER

OF

PHC-AVIATION, INC.

          The undersigned, an individual, does hereby act as incorporator in adopting the following Charter for the purpose of organizing a corporation for profit, pursuant to the provisions of the Tennessee Business Corporation Act.

          FIRST: The corporate name for the corporation (hereinafter called the “Corporation”) is PHC-Aviation, Inc.

          SECOND: The number of shares which the Corporation is authorized to issue is One Thousand (1,000), all of which are of a par value of $.01 dollars each and are of the same class and are to be Common shares.

          THIRD: The street address and zip code of the initial registered office of the Corporation in the State of Tennessee is 1900 Church Street, Suite 400, Nashville, TN 37219, county of Davidson. The name of the initial registered agent of the Corporation at the said registered office is National Registered Agents, Inc.

          FOURTH: The name and the address and zip code of the incorporator are:

NAME	ADDRESS
Gerald F. Mace	511 Union Street, Suite 2100
	Nashville, TN 37219

          FIFTH: The address of the principal office of the Corporation is 105 Westwood Place, Suite 400, Brentwood, TN 37027.

          SIXTH: No holder of any of the shares of any class of the Corporation shall be entitled as of right to subscribe for, purchase, or otherwise acquire any shares of any class of the corporation which the corporation proposes to issue or any rights or options which the corporation proposes to grant for the purchase of shares of any class of the Corporation or for the purchase of any shares, bonds, securities, or obligations of the Corporation which are convertible into or exchangeable for, or which carry any rights, to subscribe for, purchase, or otherwise acquire shares of any class of the Corporation; and any and all of such shares, bonds, securities, or obligations of the Corporation, whether now or hereafter authorized or created, may be issued, or may be reissued if the same have been reacquired and if their reissue is not prohibited, and any and all of such rights and options may be granted by the Board of Directors to such individuals and entities, and for such lawful consideration; and on such terms, as the Board of

Directors in its discretion may determine, without first offering the same, or any thereof, to any said holder.

     SEVENTH: The Corporation is for profit.

     EIGHTH: The purposes for which the Corporation is organized are as follows:

     To engage in any lawful business. To have all of the general powers granted to corporations organized under the Tennessee Business Corporation Act whether granted by specific statutory authority or by construction of law.

     NINTH: The Corporation shall, to the fullest extent permitted by the provisions of the Tennessee Business Corporation Act, as the same may be amended and supplemented, indemnify any and all persons whom it shall have power to indemnify under said provisions from and against any and all of the expenses, liabilities, or other matters referred to in or covered by said provisions, and the indemnification provided for herein shall not be deemed exclusive of any other rights to which those indemnified may be entitled under any Bylaw, vote of shareholders or disinterested directors, or otherwise, both as to action in his official capacity and as to action in another capacity while holding such office, and shall continue as to a person who has ceased to be a director, officer, employee, or agent and shall inure to the benefit of the heirs, executors, and administrators of such a person.

     TENTH: The personal liability of the directors of the Corporation is eliminated to the fullest extent permitted by the provisions of the Tennessee Business Corporation Act, as the same may be amended and supplemented.

     ELEVENTH: The duration of the corporation shall be perpetual, Signed on December 13, 2001.

/s/ Gerald F. Mace  

Gerald F. Mace, Incorporator 

CORPORATION ANNUAL REPORT [ILLEGIBLE] Annual Report. Filing Fee Due: $20. If no changes are made in block #6 to the registered agent/office, or $40. if any changes are made in block #6 to the registered agent/office Please return completed form to: TENNESSEE SECRETARY OF STATE Attn: Annual Report 312 Eighth Ave. N, 6th Floor William R. Snodgrass Tower Nashville, TN. 37243

Corporation Annual Report
Attachment

Officers

President	Martin S. Rash
Vice President	Daniel S. Slipkovich
Vice President	Christopher T. Hannon
Vice President&Treasurer	Roberto G. Pantoja
Vice President&Secretary	Howard T. Wall, III
Asst. Vice President & Controller	Steven R. Brumfield
Asst. Vice President & Secretary	Faye S. Edwards

Board of Directors

Martin S. Rash
Howard T. Wall, III

Address for Officers and Directors

105 Westwood Place
Suite 400
Brentwood, Tennessee 37027

Corporate Filings
312 Eighth Avenue North
6^th Floor, William R. Snodgrass Tower
Nashville, TN 37243

CHANGE OF REGISTERED
AGENT/OFFICE
(BY CORPORATION)

For Office Use Only

     Pursuant to the provisions of Section 48-15-102 or 48-25-108 of the Tennessee Business Corporation Act or Section 48-55-102 or 48-65-108 of the Tennessee Nonprofit Corporation Act, the undersigned corporation hereby submits this application:

     1. The name of the corporation is PHC-Aviation, Inc.

     2. The street address of its current registered office is 1900 Church Street, Suite 400, Nashville, TN 37203

     3. If the current registered office is to be changed, the street address of the new registered office, the zip code of such office, and the county in which the office is located is 800 S. Gay Street, Suite 2021, Knoxville, TN 37929 (County of Knox)

     4. The name of the current registered agent is National Registered Agents, Inc.

     5. If the current registered agent is to be changed, the name of the new registered agent is CT Corporation System

     6. After the change(s), the street addresses of the registered office and the business office of the registered agent will be identical.

July 1, 2005	PHC-Aviation, Inc.
Signature Date	Name of Corporation
Assistant Secretary	/s/ Mary Kim E. Shipp
Signer’s Capacity	Signature
	Mary Kim E. Shipp
	Name (typed or printed)

SS-4427(Rev. 6/03) Filing Fee $20.00 RDA 1678

CORPORATION ANNUAL REPORT [ILLEGIBLE] Annual Report. Filing Fee Due: $20. If no changes are made in block #6 to the registered agent/office, or $40. if any changes are made in block #6 to the registered agent/office Please return completed form to: TENNESSEE SECRETARY OF STATE Attn: Annual Report 312 Eighth Ave. N, 6th Floor William R. Snodgrass Tower Nashville, TN. 37243