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        <ExplanationTxt>APPALACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) SHARES A COMMON BOARD OF DIRECTORS AND COMMON DAY-TO-DAY MANAGEMENT WITH BLOWING ROCK HOSPITAL, INC. AND CHARLES A. CANNON JR. MEMORIAL HOSPITAL, INC. ARHS AND WATUAGA MEDICAL CENTER SHARE A MAJORITY OVERLAP OF BOARD MEMBERS AND DAY-TO-DAY MANAGEMENT. ARHS SHARES OVERLAPPING BOARD MEMBERS AND DAY-TO-DAY MANAGEMENT WITH BOTH APPALACHIAN REGIONAL HEALTHCARE FOUNDATION, APPALCHIAN REGIONAL MEDICAL ASSOCIATES, AND ARHS PROPERTIES. ARHS APPOINTS THE BOARD OF DIRECTORS OF BLOWING ROCK HOSPITAL, CHARLES A. CANNON JR. MEMORIAL HOSPITALS AND ARHS PROPERTIES. ALL ORGANIZATIONS SERVE THE HEALTHCARE NEEDS OF THE SAME NORTH CAROLINA COMMUNITIES.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc2">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>9125815</OtherCostOrOtherBasisAmt>
        <BookValueAmt>9125815</BookValueAmt>
      </LandGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>26751117</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>24633074</DepreciationAmt>
        <BookValueAmt>2118043</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>4020429</OtherCostOrOtherBasisAmt>
        <BookValueAmt>4020429</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>15264287</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>OTHER RECEIVABLES</Desc>
        <BookValueAmt>2919835</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>2919835</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO RELATED PARTIES</Desc>
        <Amt>5234121</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER LIABILITIES</Desc>
        <Amt>483856</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED INTEREST</Desc>
        <Amt>14278</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>5732255</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>ARHS AND THE COMPANIES FOR WHICH IT SERVICES AS SOLE MEMBER ARE NOT-FOR- PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN CONSIDERED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE SYSTEM HAS DETERMINED IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2021.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc3">
      <IdemnificationGrossUpPmtsInd>X</IdemnificationGrossUpPmtsInd>
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>true</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEVEN ANDERSON MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>944124</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>521988</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>15875</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>13616</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28119</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1523722</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BENJAMIN PARKER MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>516541</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>531589</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>10486</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8400</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>21949</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1088965</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES CALIFF MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>453988</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>278126</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>28564</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8400</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>27409</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>796487</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANA SOBOL MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>415632</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>209964</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>540</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>6447</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>20430</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>653013</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DOUGLAS TRATE MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>509616</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>103854</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2422</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>4891</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>29075</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>649858</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHARLES MANTOOTH</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>552256</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>14552</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>63561</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8879</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>639248</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL DAGHER MD</PersonNm>
        <TitleTxt>TRUSTEE/PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>283482</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>136030</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2281</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7205</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>29927</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>458925</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DANIELLE MAHAFFEY</PersonNm>
        <TitleTxt>CHIEF PHYS EXEC</TitleTxt>
        <BaseCompensationFilingOrgAmt>368555</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1205</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>16858</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28626</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>415244</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KEVIN MAY</PersonNm>
        <TitleTxt>CFO-LEFT 8/20</TitleTxt>
        <BaseCompensationFilingOrgAmt>227396</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>128980</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>14957</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12747</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>384080</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AMY CRABBE</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>298867</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1222</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>13794</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>14934</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>328817</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LESLIE BIANCA</PersonNm>
        <TitleTxt>WMC PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>248506</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>13678</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>13616</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10744</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>286544</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS HUYCK</PersonNm>
        <TitleTxt>CHIEF LEGAL OFCR</TitleTxt>
        <BaseCompensationFilingOrgAmt>197177</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>679</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>6447</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23197</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>227500</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROB HUDSPETH</PersonNm>
        <TitleTxt>SVP DEVELOPMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>185548</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>9251</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10383</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9458</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>214640</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CARMEN LACEY</PersonNm>
        <TitleTxt>CMH PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>167955</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>2047</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>25123</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9696</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>204821</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JIMMY MARON SIGMON</PersonNm>
        <TitleTxt>VP SUPPORT SVC</TitleTxt>
        <BaseCompensationFilingOrgAmt>165311</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>2113</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>12815</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10476</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>190715</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDES HEALTH/SOCIAL CLUB DUES THAT ARE INCLUDED ON THE OFFICERS' FORM W-2.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>STEVEN ANDERSON, MD 0 6,435 0 CHARLES MANTOOTH 0 55,161 0 DANIELLE MAHAFFEY 0 9,554 0 KEVIN MAY 110,629 11,775 0 AMY CRABBE 0 7,333 0 LESLIE BIANCA 0 6,435 0 ROB HUDSPETH 0 4,702 0 CARMEN LACEY 0 20,631 0 JIMMY MARON SIGMON 0 7,996 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>BONUS PAYMENTS BONUSES MAY BE GRANTED AT THE DISCRETION OF THE BOARD AND ARE BASED ON FACTORS SUCH AS PERFORMANCE AND MEETING GOALS AND OBJECTIVES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc4">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>ANDRE TENNILLE</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>BD MBR SPOUSE</RelationshipDescriptionTxt>
        <TransactionAmt>31779</TransactionAmt>
        <TransactionDesc>ARHS EMPLOYEE</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>CHARLES MILLER</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>BD MBR SPOUSE</RelationshipDescriptionTxt>
        <TransactionAmt>346599</TransactionAmt>
        <TransactionDesc>ARHS EMPLOYEE</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>MARCELLA MAHONEY</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>OFCR FAM MBR</RelationshipDescriptionTxt>
        <TransactionAmt>22379</TransactionAmt>
        <TransactionDesc>ARHS EMPLOYEE</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE L, PART V</FormAndLineReferenceDesc>
        <ExplanationTxt>ANDRE TENNILLE, THE SPOUSE OF BOARD MEMBER PATTIE TENNILLE, IS EMPLOYED AND COMPENSATED BY ARHS. CHARLES MILLER, THE SPOUSE OF BOARD MEMBER KIM MILLER, IS EMPLOYED AND COMPENSATED BY ARHS. MARCELLA MAHONEY IS A FAMILY MEMBER OF BOARD SECRETARY JOLYNN MAHONEY AND IS EMPLOYED AND COMPENSATED BY ARHS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIRMAN OF THE BOARD OF TRUSTEES, EX OFFICIO, AND NO MORE THAN SIX (6) OTHER TRUSTEES, AT LEAST TWO (2) OF WHOM SHALL BE AT-LARGE TRUSTEES. THE CHAIRMAN SHALL APPOINT THE MEMBERS OF THE EXECUTIVE COMMITTEE AND SHALL DESIGNATE ITS CHAIRMAN. THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE FULL POWER AND AUTHORITY TO DO ALL THINGS DEEMED NECESSARY AND EXPEDIENT IN THE GOVERNANCE, MANAGEMENT, AND CONTROL OF THE BUSINESS AND AFFAIRS OF THE CORPORATION, AND SHALL HAVE AND EXERCISE THE POWER AND AUTHORITY OF THE BOARD OF TRUSTEES TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION WHEN THE BOARD OF TRUSTEES IS NOT IN SESSION, WITH CERTAIN EXCEPTIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SVP/CFO REVIEWS THE 990 AND THEN IT IS MADE AVAILABLE TO THE BOARD UPON COMPLETION PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND APPLIES TO ALL EMPLOYEES, OFFICERS AND BOARD MEMBERS. SHOULD A CONFLICT EXIST, THE INDIVIDUAL IS RECUSED FROM DISCUSSION AND DECISION-MAKING PROCESS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>ARTHUR J. GALLAGHER &amp; CO. CONDUCTED AN INDEPENDENT COMPENSATION AND BENEFIT ANALYSIS FOR THE CEO AND EXECUTIVE TEAM OF ARHS. COMPARATIVE DATA WAS USED IN THIS ANALYSIS FROM NATIONAL AND REGIONAL PEER GROUPS (HEALTH SYSTEMS WITH COMPARABLE NET REVENUE, STRUCTURE, AND ORGANIZATIONAL COMPLEXITY). BENCHMARK DATA INCLUDED INTEGRATED HEALTHCARE STRATEGIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRACT LABOR 233,268 175,625 0 PHYSICIAN FEES 718 0 0 PURCHASED SERVICES 824,236 1,538,495 0 OUTSIDE SERVICES 5,643,465 155,586 0 CONSULTING FEES 224,194 294,329 0 COLLECTION FEES 0 1,532,735 0 TOTAL 6,925,881 3,696,770 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>EQUITY TRANSFERS RELATED ORANIZATIONS 370,352 EQUITY TRANSFERS FROM RELATED ORGANIZATIONS</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <BusinessNameLine1Txt>CHESTNUT RIDGE AT BLOWING ROCK LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>336 DEERFIELD RD</AddressLine1Txt>
          <CityNm>BOONE</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>28607</ZIPCd>
        </USAddress>
        <EIN>364767365</EIN>
        <PrimaryActivitiesTxt>REAL PROP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>ARHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>BLOWING ROCK HOSPITAL INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>P O BOX 148</AddressLine1Txt>
          <CityNm>BLOWING ROCK</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>28605</ZIPCd>
        </USAddress>
        <EIN>560513181</EIN>
        <PrimaryActivitiesTxt>REHAB</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>ARHS</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>WATAUGA MEDICAL CENTER INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>336 DEERFIELD RD</AddressLine1Txt>
          <CityNm>BOONE</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>28607</ZIPCd>
        </USAddress>
        <EIN>560510824</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>ARHS</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>APPALACHIAN REGIONAL HEALTHCARE FDN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>336 DEERFIELD RD</AddressLine1Txt>
          <CityNm>BOONE</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>28607</ZIPCd>
        </USAddress>
        <EIN>204625618</EIN>
        <PrimaryActivitiesTxt>FOUNDATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ARHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHARLES A CANNON JR MEMORIAL HOSP</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>434 HOSPITAL DR</AddressLine1Txt>
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          <StateAbbreviationCd>NC</StateAbbreviationCd>
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</Return>
