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        <PersonNm>Todd Ritchie</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>001.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Steve Westfall</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>000.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jamion Wolford</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>000.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rod Felty</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>000.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Veronica Lewis</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>000.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2305431</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>801759</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>272490</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>29</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Laboratory Corporation of America</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 12140</AddressLine1Txt>
            <CityNm>Burlington</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>272162140</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Lab Management and Testing</ServicesDesc>
        <CompensationAmt>558547</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Stephen Ulaki MD</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>54 Kristen St</AddressLine1Txt>
            <CityNm>Sandyville</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>252759399</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Staffing</ServicesDesc>
        <CompensationAmt>433719</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Medical Solutions LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1010 N 102nd St Ste 300</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>681142122</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Staffing Services</ServicesDesc>
        <CompensationAmt>374904</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Alliance Healthcare Services Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 735714</AddressLine1Txt>
            <CityNm>Dallas</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>753735714</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Imaging Services</ServicesDesc>
        <CompensationAmt>350593</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Haven LTD</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1 Haven Ln</AddressLine1Txt>
            <CityNm>Kenna</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>252488611</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Staffing</ServicesDesc>
        <CompensationAmt>320972</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>27100</FundraisingAmt>
      <GovernmentGrantsAmt>265533</GovernmentGrantsAmt>
      <TotalContributionsAmt>292633</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>47691443</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>47691443</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Walmart Clinic</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>2223882</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2223882</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Fruth General Care Clinic</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>1516534</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1516534</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Pharmacy Revenue</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>561191</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>561191</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>COVID Relief Funds</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>45228</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>45228</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>52038278</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>98896</TotalRevenueColumnAmt>
        <ExclusionAmt>98896</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>100994</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>982</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>100012</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>100012</TotalRevenueColumnAmt>
        <ExclusionAmt>100012</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <FundraisingGrossIncomeAmt>7739</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>27100</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>12783</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-5044</TotalRevenueColumnAmt>
        <ExclusionAmt>-5044</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>Cafeteria Income</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>84936</TotalRevenueColumnAmt>
        <ExclusionAmt>84936</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Use Tax Refund</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>67049</TotalRevenueColumnAmt>
        <ExclusionAmt>67049</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Rebate Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>10264</TotalRevenueColumnAmt>
        <ExclusionAmt>10264</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>46364</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>46364</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>208613</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>52733388</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>52084642</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>356113</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>908003</TotalAmt>
        <ProgramServicesAmt>473274</ProgramServicesAmt>
        <ManagementAndGeneralAmt>434729</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>17785375</TotalAmt>
        <ProgramServicesAmt>16438256</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1347119</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>498547</TotalAmt>
        <ProgramServicesAmt>470029</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28518</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3115198</TotalAmt>
        <ProgramServicesAmt>2922039</ProgramServicesAmt>
        <ManagementAndGeneralAmt>193159</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1211604</TotalAmt>
        <ProgramServicesAmt>1119833</ProgramServicesAmt>
        <ManagementAndGeneralAmt>91771</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>144820</TotalAmt>
        <ProgramServicesAmt>802</ProgramServicesAmt>
        <ManagementAndGeneralAmt>144018</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>213</TotalAmt>
        <ProgramServicesAmt>213</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>6722</TotalAmt>
        <ProgramServicesAmt>6722</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising></FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2537168</TotalAmt>
        <ProgramServicesAmt>2206274</ProgramServicesAmt>
        <ManagementAndGeneralAmt>330894</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>143130</TotalAmt>
        <ProgramServicesAmt>14600</ProgramServicesAmt>
        <ManagementAndGeneralAmt>128530</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1082593</TotalAmt>
        <ProgramServicesAmt>830612</ProgramServicesAmt>
        <ManagementAndGeneralAmt>251981</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>385599</TotalAmt>
        <ProgramServicesAmt>294960</ProgramServicesAmt>
        <ManagementAndGeneralAmt>90639</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>92623</TotalAmt>
        <ProgramServicesAmt>87421</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5202</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>54804</TotalAmt>
        <ProgramServicesAmt>41954</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12850</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>4471575</TotalAmt>
        <ProgramServicesAmt>67421</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4404154</ManagementAndGeneralAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1367417</TotalAmt>
        <ProgramServicesAmt>1046809</ProgramServicesAmt>
        <ManagementAndGeneralAmt>320608</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>1236679</TotalAmt>
        <ProgramServicesAmt>1197308</ProgramServicesAmt>
        <ManagementAndGeneralAmt>39371</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>5107153</TotalAmt>
        <ProgramServicesAmt>5107153</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Bad Debts</Desc>
        <TotalAmt>3550630</TotalAmt>
        <ProgramServicesAmt>3550630</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Taxes, Licenses Fees</Desc>
        <TotalAmt>1204889</TotalAmt>
        <ProgramServicesAmt>989213</ProgramServicesAmt>
        <ManagementAndGeneralAmt>215676</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Recruiting</Desc>
        <TotalAmt>176594</TotalAmt>
        <ProgramServicesAmt>165233</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11361</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>316256</TotalAmt>
        <ProgramServicesAmt>17692</ProgramServicesAmt>
        <ManagementAndGeneralAmt>298564</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>45397592</TotalAmt>
        <ProgramServicesAmt>37048448</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8349144</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>7409768</BOYAmt>
        <EOYAmt>2732720</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1079846</BOYAmt>
        <EOYAmt>15877978</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>3167182</BOYAmt>
        <EOYAmt>6446899</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>396732</BOYAmt>
        <EOYAmt>436739</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>386236</BOYAmt>
        <EOYAmt>138829</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>14823141</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2983069</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>9880527</BOYAmt>
        <EOYAmt>11840072</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>1350000</BOYAmt>
        <EOYAmt>1200000</EOYAmt>
      </IntangibleAssetsGrp>
      <TotalAssetsGrp>
        <BOYAmt>23670291</BOYAmt>
        <EOYAmt>38673237</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>5598149</BOYAmt>
        <EOYAmt>12605619</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>3925772</BOYAmt>
        <EOYAmt>3274997</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>320522</BOYAmt>
        <EOYAmt>2682099</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>9844443</BOYAmt>
        <EOYAmt>18562715</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>13541549</BOYAmt>
        <EOYAmt>20110522</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>284299</BOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>13825848</BOYAmt>
        <EOYAmt>20110522</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>23670291</BOYAmt>
        <EOYAmt>38673237</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>7335796</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>-1051122</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="990A" softwareId="22015461" softwareVersionNum="22.0.1.0">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="990B" softwareId="22015461" softwareVersionNum="22.0.1.0">
      <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>
    <IRS990ScheduleC documentId="990C" softwareId="22015461" softwareVersionNum="22.0.1.0">
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>6722</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>6722</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>II-B 1i</FormAndLineReferenceDesc>
        <ExplanationTxt>This amount is calculated based on information provided by the West Virginia Hospital Association and the American Hospital Association. The West Virginia Hospital Association estimates that during 2022, 13.54 of the dues paid should be allocated to lobbying expense. The American Hospital Association estimates that during 2022, 27.29 of the dues paid should be allocated to lobbying expense.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="990D" softwareId="22015461" softwareVersionNum="22.0.1.0">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>850000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>850000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>6197070</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1045811</DepreciationAmt>
        <BookValueAmt>5151259</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>390115</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>231750</DepreciationAmt>
        <BookValueAmt>158365</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3670356</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1631288</DepreciationAmt>
        <BookValueAmt>2039068</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>3715600</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>74220</DepreciationAmt>
        <BookValueAmt>3641380</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>11840072</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>Financial derivatives and other financial products</Desc>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Closely-held equity interests</Desc>
      </OtherSecuritiesGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Federal income taxes</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Leases Payable - Current</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Self Insurance Liabilities</Desc>
        <Amt>365000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Long Term Lease Liability</Desc>
        <Amt>106110</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Line of Credit - Current</Desc>
        <Amt>2210989</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>2682099</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>49163884</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>-3548430</OtherRevenueAmt>
      <RevenueNotReportedAmt>-3548430</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>52712314</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>21074</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>21074</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>52733388</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>41850144</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>982</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>982</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>41849162</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>3548430</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>3548430</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>45397592</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>X 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Most of the entities that comprise the System are tax-exempt organizations and not subject to federal or state income taxes in accordance with Section 501c3 of the Internal Revenue Code. On such basis, they will not incur any liability for income taxes, except for possible unrelated business income. AHS, WVUIS, and GHC are organizations subject to federal and/or state income taxes.The System does not have any material uncertain tax positions as of December 31, 2022 and 2021.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XI 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>This line consists of allowance for doubtful accounts of 3,548,430 which is reported as an offset to revenue on the financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XI 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>This line consists of special events expense of 12,783 that is reported as an offset to revenue on the Form 990, 34,839 of golf tournament contributions that are reported as revenue on the Form 990 but recorded in Net Assets on the financial statements, and 982 rental expense shown as an offset to revenue on the 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>This line consists of 982 expenses related to rental income that are shown as an offset to revenue on the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>This line consists of allowance for doubtful accounts of 3,548,430 which is reported as an offset to revenue on the financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <GrossReceiptsEvent1Amt>34839</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>27100</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>7739</GrossRevenueEvent1Amt>
        <CashPrizesEvent1Amt>1560</CashPrizesEvent1Amt>
        <RentFacilityCostsEvent1Amt>3115</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>611</FoodAndBeverageEvent1Amt>
        <OtherDirectExpensesEvent1Amt>7497</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>34839</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>27100</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>7739</GrossRevenueTotalEventsAmt>
        <CashPrizesTotalEventsAmt>1560</CashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>3115</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>611</FoodAndBeverageTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>7497</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>12783</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-5044</NetIncomeSummaryAmt>
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      <WrittenPolicyInd>true</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
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      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>true</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>false</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
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        <DirectOffsettingRevenueAmt>30565</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>242682</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00580</TotalExpensePct>
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      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>10247892</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>10247892</DirectOffsettingRevenueAmt>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
        <TotalCommunityBenefitExpnsAmt>151189</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>151189</DirectOffsettingRevenueAmt>
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      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>10672328</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>10429646</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>242682</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00580</TotalExpensePct>
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      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>17650</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>17650</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00040</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <CashAndInKindContributionsGrp>
        <TotalCommunityBenefitExpnsAmt>12576</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>12576</NetCommunityBenefitExpnsAmt>
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        <NetCommunityBenefitExpnsAmt>30226</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00070</TotalExpensePct>
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      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>10702554</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>10429646</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>272908</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00650</TotalExpensePct>
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      <CommunitySupportGrp>
        <TotalCommunityBenefitExpnsAmt>1103</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>1103</NetCommunityBenefitExpnsAmt>
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      <WorkforceDevelopmentGrp>
        <TotalCommunityBenefitExpnsAmt>325</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>325</NetCommunityBenefitExpnsAmt>
      </WorkforceDevelopmentGrp>
      <TotalCommuntityBuildingActyGrp>
        <TotalCommunityBenefitExpnsAmt>1428</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>1428</NetCommunityBenefitExpnsAmt>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>1133596</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>82857</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>22724344</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>19558136</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>3166208</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <OtherInd>X</OtherInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>Jackson General Hospital</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>PO Box 720</AddressLine1Txt>
          <CityNm>Ripley</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25271</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>https//wvumedicine.org/jackson-general-hospital/</WebsiteAddressTxt>
        <StateLicenseNum>52</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>Rural Health Clinic</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>A</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>false</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>21</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>false</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>https//wvumedicine.org/wp-content/uploads/2022/08/Jackson-General-Hospital-2021-Community-Health-Nee</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <RptAvailableThruOtherMethodInd>X</RptAvailableThruOtherMethodInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>22</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>https//wvumedicine.org/wp-content/uploads/2022/08/JGH-Community-Health-Implementation-Plan2022.pdf</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>0000000200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>https//wvumedicine.org/bill-pay/financial-assistance/</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>https//wvumedicine.org/bill-pay/financial-assistance/</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>https//wvumedicine.org/bill-pay/financial-assistance/</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <OtherPublicityInd>X</OtherPublicityInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <ProspectiveMedicareMedicaidInd>X</ProspectiveMedicareMedicaidInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>true</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jackson General Hospital Line Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The leadership team consisted of President/CEO of Jackson General Hospital, Stephanie McCoy Director of Finance of Jackson General Hospital, Dewey Clayton Director of Human Resources at Jackson General Hospital, Jeffrey Tabor and Director of Nursing at Jackson General Hospital, Jessica Walton. The leadership team provided thorough input throughout the process of developing the CHNA. These individuals informed the public input survey and were instrumental in dissemination. Additionally, they were charged as a group with collaborative discussion of primary and secondary data to determine health priorities. In addition to conversations with local state delegate and a local parent, the following organizations from local government, business, and non-profit organizations were represented in conversations facilitated by JGH leadership. These individuals were asked to speak to the experiences of the populations whom they serve or represent, and to discuss the accuracy of the survey data in relation to their professional and personal experiences as community members. Organizations represented in public input process included Family Resource Network, Westbrook Health Services, Recovery GPS, WVU Extension, Coordinating Council for Independent Living West Virginias Choice, Wellpoint, BCCSP, AETNA, DHHR, Pilot Club, JCDC, Try This WV, MOVRC, Childrens Home Society, JCHD, Coplin Health Systems, Jackson County Board of Education, Attorney Generals Office, Appalachian Head Start, Ravenswood Council, CRI, Pressley Ridge, Necco, Bomar Club, Reach Counseling Connection, Marshall University, HRDF, Jackson County Housing, Division of Financial Institutions, Ministerial Association, Mission WV, The Health Plan, Mountain State Education, Step by Step WV, Maximus, Southwestern Community Action Council, National Youth Advocate Program, HJK, Ripley Rotary, Ravenswood Middle School, and Public Libraries.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jackson General Hospital Line Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>The existing secondary data, new survey data, community input, and lessons learned from the last CHNA cycle all factored into JGH leaderships prioritization decisions. The list of top health concerns that will be the focus moving forward with implementation planning are Addiction Management drugs, alcohol, tobacco, food, other Mental Health COVID-19, mental illness, child psychiatry and Obesity/Unhealthy Lifestyle Solutions diabetes, heart disease, lung disease, and hypertension. Jackson General Hospital plans to address these concerns by hosting diabetes self-management and prevention classes, weight management program, school-based community walking program, community gardens for residents, healthy choices at food pantries, peer recovery coach within the emergency department, and smoking cessation programming.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jackson General Hospital Line Part V, Section B, Line 13b</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospital JGH offers discounted care only to individuals who qualify for free care. JGH offers a Prompt - Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 50 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible, for either prompt pay discount, the patient/guarantor must meet certain requirements.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jackson General Hospital Line Part V, Section B, Line 24</FormAndLineReferenceDesc>
        <ExplanationTxt>All patients are charged an amount equal to gross charges regardless of payment method. Once FAP eligibility is confirmed, charge amounts are moved to Charity Care and no longer charged to the patient.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>6</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Morad Hughes Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>PO Box 720 122 Pinnell Street</AddressLine1Txt>
            <CityNm>Ripley</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25271</ZIPCd>
          </USAddress>
          <FacilityTxt>Hospital-based rural health center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Jackson General Hospital Clinic - Walmart</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>200 Academy Drive</AddressLine1Txt>
            <CityNm>Ripley</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25271</ZIPCd>
          </USAddress>
          <FacilityTxt>Urgent Care Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Jackson General Care Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>509 South Church Street</AddressLine1Txt>
            <CityNm>Ripley</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25271</ZIPCd>
          </USAddress>
          <FacilityTxt>Urgent Care Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Jackson Premier Health</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>146 Pinnell Street</AddressLine1Txt>
            <CityNm>Ripley</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25271</ZIPCd>
          </USAddress>
          <FacilityTxt>Provider-based health clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Primary Family Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>174 Pinnell Street</AddressLine1Txt>
            <CityNm>Ripley</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25271</ZIPCd>
          </USAddress>
          <FacilityTxt>Provider-based health clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Jackson General Hospital Sports Medicine</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>511 Washington Street</AddressLine1Txt>
            <CityNm>Ravenswood</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>26164</ZIPCd>
          </USAddress>
          <FacilityTxt>Physical Therapy Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3c</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospital uses 200 Federal Poverty Guideline to determine free care eligibility. JGH offers a Prompt - Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 50 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible for either discount the patient/guarantor must meet certain requirements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospital, Inc., community benefit numbers are reported in total with other hospitals within the West Virginia United Health System. The most recent amounts can be found on WVU Medicines website here https//wvumedicine.org/about/leadership-and-more/community-benefit/</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Column f - Total community benefit expense for 2022 is 10,702,554 and is 25.57 of total net expenses. To calculate net expense, bad debt of 3,548,432 was deducted from total expenses of 45,397,592 as shown in Part IX line 25 of the core Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Worksheet 2 from the IRS Schedule H instructions was used to derive the Cost-to-charge ratio, which was used to calculate Charity Care, Unreimbursed Medicaid and other means-tested government programs at cost. To calculate the Medicare allowable cost shown in Part III question 8, we used the allowable costs from the Medicare Cost report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>During 2022 Jackson participated community building activities such as Community Support with employees of Jackson participating in youth camps and board meetings of area non-profits. Workforce Development - members of Jacksons staff attended local high school job fairs and career days to provide information on jobs available in the medical field.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debt Expense at Cost on Line 2 was calculated by multiplying bad debt expense of 3,548,432 by our cost-to-charge ratio of 35.97 for a total of 1,276,371 less DSH allocations to self-pay patient accounts of 142,775 for a total of 1,133,596.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Estimated bad debt attributable to patients eligible for charity care on Line 3 was calculated by pulling all outstanding patient balances of 5,000 or greater from our patient accounting system. That report totaled 230,352, which was then multiplied by the cost-to-charge ratio of 35.97 for a total of 82,858.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>We feel that at a minimum, the estimated bad debt attributable to patients eligible for charity care of 82,858 should be considered community benefit due to the fact that anyone with outstanding balances of 5,000 or greater in our demographic usually qualifies as catastrophic if the patient completes the application process. In our Charity Care Policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year and would have qualified for charity care if paperwork was completed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospitals financial statements are prepared on a consolidated basis as a member of the WV United Health System. The footnote for Accounts Receivable is as follows Patient accounts receivable are reported at net realizable value. For accounts receivable associated with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The System grants credit without collateral to its patients, most of whom are local residents, and are insured under third-party payor agreements, primarily with Medicare, Medicaid and various commercial insurance companies. The System records accounts receivable net of estimated prince concessions and such amounts have historically been within managements expectations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The mix of accounts receivable at December 31, 2022 and 2021, from patients and third-party payors is as follows For the year-end December 31, 2022 Medicare - 27, Medicaid - 16, Blue Cross - 19, Commercial, managed care and other - 35, Patients - 3, totaling 100. For the year-end December 31, 2021, Medicare - 31, Medicaid - 16, Blue Cross - 21, Commercial, managed care and other - 28, Patients - 4, totaling 100.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Medicare costs and revenues were obtained from the hospitals Medicare cost report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>JGH does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity care, the patient will not be sent to a bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospital utilized the following strategies to successfully perform their health care needs assessment. These included assembly of a Health Advisory Committee comprised of representative from community leaders, health care providers, and citizens to guide the assessment process, conduct primary data collection through surveys of providers, key informants, and the general population, collect and analyze secondary data sources and create a comprehensive community health care services inventory. In addition to this, hospital leadership also outlined specific goals of the needs assessment. These were to identify the following health care issues in the community, vulnerable populations, disparities in the health care services delivery system, health care resources in the community and the next steps to take to meet the health care needs of the residents of Jackson County, WV.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospital employs one financial analyst to meet with patients to discuss financial eligibility for our charity care program. Jackson General Hospital has the qualification requirements, as well as, applications for charity care available at all registration areas. Patients that do not qualify for state or federally funded programs can apply for the charity care program at Jackson General Hospital.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospital JGH is a not for profit, critical access hospital located in Jackson County, WV in the town of Ripley. JGH provides emergency care, imaging services, nuclear medicine, gynecology, ophthalmology, orthopedics, pain management, pediatric, primary and surgical care. JGH also provides a variety of rehabilitation services such as infusion, occupational, physical, respiratory therapy. In 2022, Jackson County had a total population of 27,716 a median household income of 53,165, an employment rate of 46.6 and 7.4 of residents reported they were without healthcare coverage. Population and demographic information was obtained from the United States Census Bureau https//data.census.gov/cedsci/.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospitals board of directors is a community board, with all board members living in or around Jackson County, WV. Jackson General Hospital extends privileges to all qualified medical staff in Jackson County and surrounding communities to meet its healthcare needs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Jackson General Hospital is a part of the West Virginia University Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of WVUHS states intent to build a regional health care delivery system in its services area, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>WVUHSs management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include West Virginia University Hospitals in Morgantown, WV, United Hospital Center in Bridgeport, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Camden-Clark Medical Center in Parkersburg, WV, Potomac Valley Hospital in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Hospital in Glen Dale, WV, Braxton County Memorial Hospital in Gassaway, WV, Summersville Regional Medical Center in Summersville, WV, Wetzel County Hospital, Inc. in New Martinsville, WV, Harrison Community Hospital in Cadiz, OH, Wheeling Hospital, Inc. in Wheeling, WV, Uniontown Hospital in Uniontown, PA, Barnesville Hospital Association in Barnesville, OH, and GRMC, Inc. in Oakland, MD was acquired July 1, 2022..</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>In addition to the above mentioned hospitals, the System includes physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, Inc. a behavioral health center located in Clarksburg, WV. The System also includes, WVUH-East, Inc. and Camden-Clark Health Services, Inc. which operate as management companies for their respective hospitals. University Healthcare Foundation, Inc. in Martinsburg, WV, United Health Foundation, Inc. in Bridgeport, WV, Camden-Clark Foundation, Inc. in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, Inc. in Glen Dale, WV, which perform various fundraising activities for their respective hospitals. In 2020, the System formed WVUHS Home Care, LLC to provide Home Health and Hospice services to our service areas, supporting System hospitals by providing continuous care to our patients. Wheeling Hospital Ambulatory Surgical Center, LLC a surgical center located in Bridgeport, OH was acquired in 2021.</ExplanationTxt>
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        <PersonNm>Steve Altmiller</PersonNm>
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        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Per the WVUHS Incentive Plan incentives are contingent on meeting a net earning target.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Stephanie McCoy received deferred compensation contributions of 18,665 in 2022. This amount is properly recorded in deferred compensation on the Form 990 Schedule J.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Steve Altmiller received CAA cash distributions of 89,690 from related party in 2022.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation for CEOs are determined by the WV United Health System compensation committee. The System engages an independent group to perform an executive compensation review and compensation survey every two years. This information is provided to the committee, which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package offered does not exceed fair market value.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d</FormAndLineReferenceDesc>
        <ExplanationTxt>Program Service Expenses 13,268,596, Grants and allocations 0, Revenue 16,994,823 JGH also provides imaging services, nuclear medicine, gynecology, ophthalmology, orthopedics, pain management, pediatric, and surgical care. JGH also provides a variety of rehabilitation services such as infusion, occupational, physical, respiratory therapy, cardiac rehab, wound care, and speech therapy.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d</FormAndLineReferenceDesc>
        <ExplanationTxt>Program Service Expenses 14,676, Grants and allocations 0, Revenue 0 The organization provided several community health improvement services, including a patient/community resource center, free sports physicals, prostate screenings, cardiac kits, advance directives presentations, CPR and first aid classes, diabetic counseling, health fairs, County Disaster Preparedness, and various other programs. Costs related to these totaled 14,676.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part I, Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>of health, both personal and public.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The 990 is reviewed by the CEO and Director of Finance and a copy is provided to members of the finance / executive committee before it is filed with the IRS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization requires all board members, officers, key employees, and committee members to annually review and fill out a form which verifies compliance with the written conflict of interest policy. The signing of this document occurs immediately after the annual meeting.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15 a b</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the CEO is determined by the WV United Health System Compensation Committee based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This information is provided to the compensation committee which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package does not exceed fair market value based on the data from the consultant group. The minutes of the compensation committee are contemporaneously documented and retained. A full compensation survey was completed in 2021 for 2022 compensation amounts. The compensation of all officers at the Vice President level and below is determined based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This data is then interpreted and provided to an independent compensation committee. The independent compensation committee then uses this data to determine a fair and reasonable compensation package. All relevant data as well as minutes from each meeting are retained.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents, conflict of interest policy, and financial statements are available to anyone in the public upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Line 11g consists of the following 43,606 Consulting and Professional Fees of which 1,875 are considered program service expense and 41,731 are considered management and general expense 2,484,214 Contracted Labor/Purchased Services of which 2,196,248 are considered program services expenses and 287,966 are considered management and general expenses 535 Chart Enhancement Fees all of which are considered program service expenses and 8,813 Collection Agency Fees of which 7,616 are considered program service expenses and 1,197 are considered management and general expenses.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>This amount consists of 744,764 related organization capitalization, 12,783 expenses from special events reported as an offset to revenue on the 990 but recorded in net assets in the general ledger, 284,299 change in restricted net assets for the period, 34,839 of golf tournament proceeds that are reported as revenue on the 990 but recorded in net assets on the financials, and 3 rounding.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 4 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The organizations articles and bylaws were updated during 2022 to reflect that West Virginia United Health System, Inc., a 501c3 charitable organization WVUHS, is the sole member of the organization, streamline the reserved powers of WVUHS reflected in the organizations articles of incorporation and bylaws, and update the organizations rules and regulations to be consistent with the governance processes followed by the other tax-exempt hospitals of which WVUHS is the sole member.</ExplanationTxt>
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        <PublicCharityStatusTxt>12 Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>United Hospital Center Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>United Hospital Center Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>327 Medical Park Drive</AddressLine1Txt>
          <CityNm>Bridgeport</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26330</ZIPCd>
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        <EIN>550525724</EIN>
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        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>United Physicians Care Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>686 South Pike Street</AddressLine1Txt>
          <CityNm>Shinnston</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26431</ZIPCd>
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        <EIN>550638563</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>United Hospital Center Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>United Summit Center</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>6 Hospital Plaza</AddressLine1Txt>
          <CityNm>Clarksburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26301</ZIPCd>
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        <EIN>550752788</EIN>
        <PrimaryActivitiesTxt>Behavioral Health</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>West Virginia Health Care Cooperative Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>400 Fairview Heights Rd</AddressLine1Txt>
          <CityNm>Summersville</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26651</ZIPCd>
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        <EIN>550650441</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Memorial Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 Garfield Ave</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
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        <EIN>311524546</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 Garfield Ave</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
        </USAddress>
        <EIN>550769602</EIN>
        <PrimaryActivitiesTxt>Healthcare Access</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 Garfield Ave</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
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        <EIN>550667789</EIN>
        <PrimaryActivitiesTxt>Hospital Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Physician Corp</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>604 Ann Street</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
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        <EIN>264058719</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Potomac Valley Hospital of W Va Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 Pin Oak Lane</AddressLine1Txt>
          <CityNm>Keyser</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26726</ZIPCd>
        </USAddress>
        <EIN>550420956</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Joseph's Hospital of Buckhannon Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Amalia Drive</AddressLine1Txt>
          <CityNm>Buckhannon</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26201</ZIPCd>
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        <EIN>550356996</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Joseph's Foundation of Buckhannon Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Amalia Drive</AddressLine1Txt>
          <CityNm>Buckhannon</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>St Joseph's Hospital of Buckhannon Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Reynolds Memorial Hospital Inc</BusinessNameLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26038</ZIPCd>
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        <EIN>550357045</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Reynolds Memorial Foundation</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Braxton County Memorial Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>100 Hoylman Drive</AddressLine1Txt>
          <CityNm>Gassaway</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26624</ZIPCd>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Wetzel County Hospital Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>3 East Benjamin Drive</AddressLine1Txt>
          <CityNm>New Martinsville</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26155</ZIPCd>
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        <EIN>843480493</EIN>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WVUHS Home Care LLC</BusinessNameLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26506</ZIPCd>
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        <EIN>852915642</EIN>
        <PrimaryActivitiesTxt>Home Health and Hospice</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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          <BusinessNameLine1Txt>Fayette Physician Network</BusinessNameLine1Txt>
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          <AddressLine1Txt>500 West Berkeley Street</AddressLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
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          <BusinessNameLine1Txt>Harrison Community Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>951 E Market Street</AddressLine1Txt>
          <CityNm>Cadiz</CityNm>
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          <ZIPCd>43907</ZIPCd>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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          <BusinessNameLine1Txt>Harrison Community Hospital Foundation</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>951 E Market Street</AddressLine1Txt>
          <CityNm>Cadiz</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43907</ZIPCd>
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        <EIN>341571749</EIN>
        <PrimaryActivitiesTxt>Hospital Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>509a2</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Harrison Community Hospital</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Barnesville Hospital Association</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>639 W Main Street</AddressLine1Txt>
          <CityNm>Barnesville</CityNm>
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          <ZIPCd>43713</ZIPCd>
        </USAddress>
        <EIN>340719172</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Belmont Community Hospital</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>4697 Harrison Street</AddressLine1Txt>
          <CityNm>Bellaire</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43906</ZIPCd>
        </USAddress>
        <EIN>340714643</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Wheeling Hospital Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Medical Park Foundation</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
          <CityNm>Wheeling</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
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        <EIN>550744690</EIN>
        <PrimaryActivitiesTxt>Church</PrimaryActivitiesTxt>
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        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>Wheeling Hospital Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Self Insurance Trust Agreement of Wheeling Hospital Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
          <CityNm>Wheeling</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
        </USAddress>
        <EIN>550676674</EIN>
        <PrimaryActivitiesTxt>Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>GRMC Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>251 North Fourth Street</AddressLine1Txt>
          <CityNm>Oakland</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21550</ZIPCd>
        </USAddress>
        <EIN>871846814</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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          <AddressLine1Txt>PO Box 8034</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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          <BusinessNameLine1Txt>Allied Health Sourcing Solutions</BusinessNameLine1Txt>
        </RelatedOrganizationName>
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          <AddressLine1Txt>PO Box 8034</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
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          <BusinessNameLine1Txt>Allied Health Services Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>PO Box 782</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26507</ZIPCd>
        </USAddress>
        <EIN>550652017</EIN>
        <PrimaryActivitiesTxt>Medical Lab</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>West Virginia United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>West Virginia United Insurance Services</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>3040 University Avenue Suite 3200</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26505</ZIPCd>
        </USAddress>
        <EIN>550756055</EIN>
        <PrimaryActivitiesTxt>Provider Network</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>West Virginia United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
