﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2024v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-11-13T13:46:34+00:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>135565207</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>KPMG LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>515 Broadway 4th Floor</AddressLine1Txt>
        <CityNm>Albany</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>12207</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>150539039</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Aurelia Osborn Fox Memorial Hospital</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>AURE</BusinessNameControlTxt>
      <PhoneNum>6074315900</PhoneNum>
      <USAddress>
        <AddressLine1Txt>1 NORTON AVE</AddressLine1Txt>
        <CityNm>ONEONTA</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>13820</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>STACI THOMPSON</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <SignatureDt>2025-11-13</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Geneva Furlano</PreparerPersonNm>
      <PTIN>P01877392</PTIN>
      <PhoneNum>5184274600</PhoneNum>
      <PreparationDt>2025-11-12</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="IRS990" softwareId="24020961" softwareVersionNum="2024v5.1">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>AO FOX MEMORIAL HOSPITAL</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfcrBusinessName>
        <BusinessNameLine1Txt>STACI THOMPSON</BusinessNameLine1Txt>
      </PrincipalOfcrBusinessName>
      <USAddress>
        <AddressLine1Txt>1 NORTON AVE</AddressLine1Txt>
        <CityNm>ONEONTA</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>13820</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>113429607</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.AOFOXHOSPITAL.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1900</FormationYr>
      <LegalDomicileStateCd>NY</LegalDomicileStateCd>
      <ActivityOrMissionDesc>SEE SCHEDULE O</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>12</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>12</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>709</TotalEmployeeCnt>
      <TotalVolunteersCnt>17</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>8662368</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>3227354</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>6874602</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>91912653</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>105372836</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>214352</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>536365</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>943240</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>645804</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>96297599</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>113429607</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>42771951</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>47537968</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>130252</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>55613143</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>57338976</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>98385094</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>104876944</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-2087495</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>8552663</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>59864117</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>62063392</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>28590569</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>21913533</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>31273548</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>40149859</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>SEE SCHEDULE O</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>79958358</ExpenseAmt>
      <RevenueAmt>94904091</RevenueAmt>
      <Desc>HEALTH CARE DELIVERY: INCLUDES: UNCOMPENSATED CARE, PAYMENTS INTO BAD DEBT AND CHARITY POOLS, NYS HEALTH FACILITIES ASSESSMENT, COMMUNITY EDUCATION, MATERNAL CARE PROGRAM, COST OF PROVIDING SERVICES TO GOVERNMENT PAYORS. HEALTH/WELLNESS AND EDUCATIONAL SERVICES TO THE GENERAL PUBLIC. IN 2024 THE HOSPITAL HAD OVER 7,000 PATIENT DAYS, 24,000 EMERGENCY ROOM VISITS, AND 60,000 OUTPATIENT VISITS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>10138944</ExpenseAmt>
        <RevenueAmt>10468745</RevenueAmt>
        <Desc>NURSING HOME CARE - NURSING HOME FACILITY - SKILLED NURSING, HEALTH AND RESPITE CARE.</Desc>
      </ProgSrvcAccomActy2Grp>
      <TotalProgramServiceExpensesAmt>90097302</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="IRS990ScheduleC">true</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="IRS990ScheduleC">false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd>false</DonorAdvisedFundInd>
      <ConservationEasementsInd>false</ConservationEasementsInd>
      <CollectionsOfArtInd>false</CollectionsOfArtInd>
      <CreditCounselingInd>false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="IRS990ScheduleD">true</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd>false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd referenceDocumentId="IRS990ScheduleH">true</OperateHospitalInd>
      <AuditedFinancialStmtAttInd referenceDocumentId="AuditedFinancialStatements">true</AuditedFinancialStmtAttInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="IRS990ScheduleR">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>true</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="IRS990ScheduleR">true</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>76</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>709</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>12</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>12</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>true</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <PoliciesReferenceChaptersInd>false</PoliciesReferenceChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <WrittenPolicyOrProcedureInd>false</WrittenPolicyOrProcedureInd>
      <StatesWhereCopyOfReturnIsFldCd>NY</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>CRAIG FAERBER</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>6074315900</PhoneNum>
        <USAddress>
          <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
          <CityNm>ONEONTA</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13820</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cheryl Robinson</PersonNm>
        <TitleTxt>Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Christy Coe</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Noel Goodspeed</PersonNm>
        <TitleTxt>Chair</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Thomas Brindley</PersonNm>
        <TitleTxt>Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Wade Harman</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Alberto Cardelle</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>David Dugan DDS MD</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Edward Curley</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jeffrey Lord</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lynn Glueckert</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mary Ellen Hoffman MD</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Scott McLean</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Craig Faerber</PersonNm>
        <TitleTxt>Interim Network CFO</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>56.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>524460</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dan Croft MD</PersonNm>
        <TitleTxt>Hospital Vice President Medical Affairs</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>362989</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35176</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Joan MacDonald</PersonNm>
        <TitleTxt>VP Operations/CNO</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>217647</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11345</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Staci Thompson</PersonNm>
        <TitleTxt>BHN President and CEO</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>52.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>866810</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12117</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Ann Skinner</PersonNm>
        <TitleTxt>CT Tech II</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>160868</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10509</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Benjamin Wood</PersonNm>
        <TitleTxt>Clin Informatics Pharm</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>163385</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17225</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kyle Marks</PersonNm>
        <TitleTxt>Pharmacist II</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>159840</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12627</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maia Decker</PersonNm>
        <TitleTxt>Pharmacy Inpatient Manager</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>172914</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23798</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Margaret Wikoff</PersonNm>
        <TitleTxt>Nurse Manager - Nursing</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>159275</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17603</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tommy Ibrahim MD</PersonNm>
        <TitleTxt>Former President</TitleTxt>
        <AverageHoursPerWeekRt>0.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>411723</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12888</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1033929</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>2165982</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>153288</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>79</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>true</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DAVIN HEALTHCARE WORKFORCE SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>18 DIVISION STREET SUITE 311</AddressLine1Txt>
            <CityNm>SARATOGA</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>12866</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>AGENCY STAFFING</ServicesDesc>
        <CompensationAmt>3798921</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MORRISON MANAGEMENT SPECIALISTS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5801 PEACHTREE DUNWOODY ROAD</AddressLine1Txt>
            <CityNm>ATLANTA</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>30342</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>NUTRITIONAL SERVICES</ServicesDesc>
        <CompensationAmt>2294491</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PROLINK HEALTHCARE LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4600 MONTGOMERY PLACE SUITE 300</AddressLine1Txt>
            <CityNm>CINCINNATI</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45212</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>AGENCY STAFFING</ServicesDesc>
        <CompensationAmt>2225208</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MAYO COLLABORATIVE SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>200 FIRST STREET SOUTHWEST</AddressLine1Txt>
            <CityNm>ROCHESTER</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>55905</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LAB SERVICES</ServicesDesc>
        <CompensationAmt>1197682</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MEDICAL SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 850757</AddressLine1Txt>
            <CityNm>MINNEAPOLIS</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>55485</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>AGENCY STAFFING</ServicesDesc>
        <CompensationAmt>1101751</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>24</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>326157</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>6401207</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>147238</AllOtherContributionsAmt>
      <TotalContributionsAmt>6874602</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>HOSPITAL</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>94051980</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>94051980</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>NURSING HOME</Desc>
        <BusinessCd>623990</BusinessCd>
        <TotalRevenueColumnAmt>10786892</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10786892</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>533964</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>533964</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>105372836</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>526664</TotalRevenueColumnAmt>
        <ExclusionAmt>526664</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>645804</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>645804</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>645804</TotalRevenueColumnAmt>
        <ExclusionAmt>645804</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>9701</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>9701</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>9701</TotalRevenueColumnAmt>
        <ExclusionAmt>9701</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>113429607</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>105372836</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1182169</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>228992</TotalAmt>
        <ProgramServicesAmt>228992</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>37923818</TotalAmt>
        <ProgramServicesAmt>32587899</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5228865</ManagementAndGeneralAmt>
        <FundraisingAmt>107054</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1419217</TotalAmt>
        <ProgramServicesAmt>1219114</ProgramServicesAmt>
        <ManagementAndGeneralAmt>200103</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>5335132</TotalAmt>
        <ProgramServicesAmt>4588757</ProgramServicesAmt>
        <ManagementAndGeneralAmt>740109</ManagementAndGeneralAmt>
        <FundraisingAmt>6266</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>2630809</TotalAmt>
        <ProgramServicesAmt>2262764</ProgramServicesAmt>
        <ManagementAndGeneralAmt>368045</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>6825974</TotalAmt>
        <ManagementAndGeneralAmt>6825974</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>52195</TotalAmt>
        <ManagementAndGeneralAmt>52195</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>27300</TotalAmt>
        <ManagementAndGeneralAmt>27300</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>16890</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16890</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>20027589</TotalAmt>
        <ProgramServicesAmt>20010657</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>16932</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>3548</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3548</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1186361</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1186361</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>3588275</TotalAmt>
        <ProgramServicesAmt>3588275</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>31027</TotalAmt>
        <ProgramServicesAmt>31027</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>35814</TotalAmt>
        <ProgramServicesAmt>35814</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>6139</TotalAmt>
        <ProgramServicesAmt>6139</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>3539671</TotalAmt>
        <ProgramServicesAmt>3539671</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>134440</TotalAmt>
        <ProgramServicesAmt>134440</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>6274231</TotalAmt>
        <ProgramServicesAmt>6274231</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DRUGS AND REAGENTS</Desc>
        <TotalAmt>4056764</TotalAmt>
        <ProgramServicesAmt>4056764</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>2276792</TotalAmt>
        <ProgramServicesAmt>2276792</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CHARITY CARE</Desc>
        <TotalAmt>815309</TotalAmt>
        <ProgramServicesAmt>815309</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>8440657</TotalAmt>
        <ProgramServicesAmt>8440657</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>104876944</TotalAmt>
        <ProgramServicesAmt>90097302</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14649390</ManagementAndGeneralAmt>
        <FundraisingAmt>130252</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <TotalJointCostsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalJointCostsGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>6695530</BOYAmt>
        <EOYAmt>7648340</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>1768733</BOYAmt>
        <EOYAmt>1485814</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>10003353</BOYAmt>
        <EOYAmt>12340757</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1685878</BOYAmt>
        <EOYAmt>1745204</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>590996</BOYAmt>
        <EOYAmt>825278</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>137343521</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>106611304</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>30082318</BOYAmt>
        <EOYAmt>30732217</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>1138991</BOYAmt>
        <EOYAmt>866288</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>7898318</BOYAmt>
        <EOYAmt>6419494</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>59864117</BOYAmt>
        <EOYAmt>62063392</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>6347516</BOYAmt>
        <EOYAmt>6252336</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>1225270</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>21017783</BOYAmt>
        <EOYAmt>15661197</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>28590569</BOYAmt>
        <EOYAmt>21913533</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>30155625</BOYAmt>
        <EOYAmt>45655223</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>1117923</BOYAmt>
        <EOYAmt>-5505364</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>31273548</BOYAmt>
        <EOYAmt>40149859</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>59864117</BOYAmt>
        <EOYAmt>62063392</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>8552663</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>111653</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>211995</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="24020961" softwareVersionNum="2024v5.1">
      <HospitalInd>X</HospitalInd>
      <GiftsGrantsContriRcvd170Grp>
        <TotalAmt>0</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TaxRevLeviedOrgnztnlBnft170Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft170Grp>
      <GovtFurnSrvcFcltsVl170Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>0</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>0</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <TotalAmt>0</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <TotalAmt>0</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>0</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>0</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.0</PublicSupportPY170Pct>
      <GiftsGrantsContrisRcvd509Grp>
        <TotalAmt>0</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <TotalAmt>0</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <TotalAmt>0</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <GovtFurnSrvcFcltsVl509Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>0</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <TotalAmt>0</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <TotalAmt>0</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <TotalAmt>0</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.0</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.0</InvestmentIncomePYPct>
      <PrivateFoundation509Ind>X</PrivateFoundation509Ind>
      <DistributableAmountGrp>
        <CYAdjNetIncomeDistributableAmt>0</CYAdjNetIncomeDistributableAmt>
        <CYPct85AdjustedNetIncomeAmt>0</CYPct85AdjustedNetIncomeAmt>
        <CYTotalMinAstDistributableAmt>0</CYTotalMinAstDistributableAmt>
        <CYGreaterAdjustedMinimumAmt>0</CYGreaterAdjustedMinimumAmt>
        <CYIncomeTaxImposedPYAmt>0</CYIncomeTaxImposedPYAmt>
        <CYDistributableAsAdjustedAmt>0</CYDistributableAsAdjustedAmt>
      </DistributableAmountGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="24020961" softwareVersionNum="2024v5.1">
      <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="IRS990ScheduleC" softwareId="24020961" softwareVersionNum="2024v5.1">
      <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>16890</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>16890</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY</FormAndLineReferenceDesc>
        <ExplanationTxt>LOBBYING ACTIVITIES: A PERCENTAGE OF MEMBERSHIP DUES PAID TO IROQUOIS HEALTHCARE ALLIANCE (50%) AND AMERICAN HOSPITAL ASSOCATION (39%) ARE USED SPECIFICALLY FOR LOBBYING PURPOSES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="24020961" softwareVersionNum="2024v5.1">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>3383758</BeginningYearBalanceAmt>
        <ContributionsAmt>1123585</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>88439</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>80614</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>76774</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>4438394</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>3183030</BeginningYearBalanceAmt>
        <ContributionsAmt>696323</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>101634</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>21358</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>575871</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3383758</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>7261200</BeginningYearBalanceAmt>
        <ContributionsAmt>70073</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-4019611</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>4497</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>124135</OtherExpendituresAmt>
        <EndYearBalanceAmt>3183030</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>6878258</BeginningYearBalanceAmt>
        <ContributionsAmt>783492</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>186149</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>586699</OtherExpendituresAmt>
        <EndYearBalanceAmt>7261200</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>6481701</BeginningYearBalanceAmt>
        <ContributionsAmt>451384</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>377261</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>432088</OtherExpendituresAmt>
        <EndYearBalanceAmt>6878258</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.3549</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.3788</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.2663</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>true</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>true</RelatedOrgListSchRInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>2067776</OtherCostOrOtherBasisAmt>
        <BookValueAmt>2067776</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>63522753</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>42633461</DepreciationAmt>
        <BookValueAmt>20889292</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>3624927</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2040605</DepreciationAmt>
        <BookValueAmt>1584322</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>67007179</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>61937238</DepreciationAmt>
        <BookValueAmt>5069941</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>1120886</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1120886</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>30732217</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>OPERATING LEASE - RIGHT OF USE</Desc>
        <BookValueAmt>1800529</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RESTRICTED FUNDS</Desc>
        <BookValueAmt>4438394</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OTHER ASSETS</Desc>
        <BookValueAmt>180571</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>6419494</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Federal Income Taxes</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED PENSION LIABILITY</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITIES - OPERATING</Desc>
        <Amt>1788357</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITIES - FINANCING</Desc>
        <Amt>208967</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO RELATED PARTIES</Desc>
        <Amt>7427202</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ESTIMATED THIRD PARTY PAYABLES</Desc>
        <Amt>6236671</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>15661197</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>0</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>0</TotalRevenuePerForm990Amt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>0</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>0</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part V, Line 4 Intended uses of endowment funds</FormAndLineReferenceDesc>
        <ExplanationTxt>PERMANENT ENDOWMENTS: THE INTENDED USE OF THE INCOME FROM THESE FUNDS IS TO SUPPORT OPERATIONS, FUND THE ANNUAL PHYSICIANS LECTURES AND DINNERS. BOARD DESIGNATED OR QUASI ENDOWMENTS: THE INTENDED USE OF INCOME FROM THESE FUNDS IS TO SUPPORT OPERATIONS OR FOR THE FUTURE CAPITAL NEEDS. TERM ENDOWMENTS: THE INTENDED USE OF THESE FUNDS IS DETERMINED BY THE VARIOUS DONORS, AND TO PROVIDE FOR THE NEEDS OF NURSING HOME PATIENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>FIN 48 FOOTNOTE AURELIA OSBORN FOX MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF BASSETT HEALTHCARE NETWORK (THE NETWORK). THE TEXT OF THE FIN 48 FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS IS AS FOLLOWS: THE NETWORK'S VARIOUS SUBSIDIARIES GENERALLY CONSIST OF NOT-FOR-PROFIT CORPORATIONS ORGANIZED IN ACCORDANCE WITH SECTION 501(C)(3) OF THE IRC AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE IRC. THE NETWORK RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES OR UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED. FOR TAXABLE SUBSIDIARIES OR INVESTMENTS, INCLUDING CCE, DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES OF TEMPORARY DIFFERENCES BY APPLYING ENACTED STATUTORY TAX RATES APPLICABLE TO FUTURE YEARS FOR THE DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENTS AND TAX BASIS OF EXISTING ASSETS AND ABILITIES. SUCH DEFERRED TAX ASSETS AND LIABILITIES WERE NOT MATERIAL AS OF DECEMBER 31, 2024 AND 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH" softwareId="24020961" softwareVersionNum="2024v5.1">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent400Ind>X</Percent400Ind>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>399769</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>91707</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>308062</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00294</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>19461272</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>14771025</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4690247</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04472</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </UnreimbursedCostsGrp>
      <TotalFinancialAssistanceTyp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>19861041</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>14862732</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4998309</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04766</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>783799</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>128629</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>655170</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00625</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>16342219</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>15298512</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>1043707</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00995</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <ResearchGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </ResearchGrp>
      <CashAndInKindContributionsGrp>
        <TotalCommunityBenefitExpnsAmt>61086</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>61086</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00058</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>17187104</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>15427141</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>1759963</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01678</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>37048145</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>30289873</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>6758272</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.06444</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <PhysicalImprvAndHousingGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </PhysicalImprvAndHousingGrp>
      <EconomicDevelopmentGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </EconomicDevelopmentGrp>
      <CommunitySupportGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </CommunitySupportGrp>
      <EnvironmentalImprovementsGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </EnvironmentalImprovementsGrp>
      <LeadershipDevelopmentGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </LeadershipDevelopmentGrp>
      <CoalitionBuildingGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </CoalitionBuildingGrp>
      <HealthImprovementAdvocacyGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </HealthImprovementAdvocacyGrp>
      <WorkforceDevelopmentGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </WorkforceDevelopmentGrp>
      <OtherCommuntityBuildingActyGrp>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </OtherCommuntityBuildingActyGrp>
      <TotalCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <ReimbursedByMedicareAmt>18718183</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>20849512</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-2131329</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>1 AT HOME CARE</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>REGIONAL HOME HEALTH AGENCY</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.5</OrgProfitOrOwnershipPct>
        <OfcrEtcProfitOrOwnershipPct>0.0</OfcrEtcProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.0</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>AURELIA OSBORN FOX MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
          <CityNm>ONEONTA</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13820</ZIPCd>
        </USAddress>
        <StateLicenseNum>3801000</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>AURELIA OSBORN FOX MEMORIAL HOSPITAL</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>22</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>true</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>true</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>http://www.bassett.org/locations/ao-fox-hospital-tri-town-campus</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>22</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>http://www.bassett.org/locations/ao-fox-hospital-tri-town-campus</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>200.0</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>400.0</FPGFamilyIncmLmtDscntCarePct>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <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>http://www.bassett.org/patients-visitors/billing-insurance/financial-assistance</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>http://www.bassett.org/patients-visitors/billing-insurance/financial-assistance</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>http://www.bassett.org/patients-visitors/billing-insurance/financial-assistance</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 5 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - AURELIA OSBORN FOX MEMORIAL HOSPITAL. THE BASSETT HEALTHCARE NETWORK POPULATION HEALTH DEPARTMENT (BHNPHD), ON BEHALF OF BASSETT HEALTHCARE NETWORK'S A.O. FOX HOSPITAL, MARY IMOGENE BASSETT MEDICAL CENTER, AND OTSEGO COUNTY PUBLIC HEALTH HAS COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) / COMMUNITY HEALTH ASSESSMENT (CHA). THE COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE HOSPITAL, LOCAL COUNTY HEALTH DEPARTMENT, AND KEY INFORMANTS WITH DATA AND RESPONSES SO THAT THEY MAY IDENTIFY, PRIORITIZE, AND ADDRESS HEALTH CARE CHALLENGES FACING THEIR COMMUNITIES. THE BHNPHD COLLABORATED WITH OTSEGO COUNTY PUBLIC HEALTH TO COMPILE A LIST OF KEY INFORMANTS IN THE SERVICE REGION. THOSE KEY INFORMANTS REPRESENT A BROAD RANGE OF SECTORS, COMMUNITY INTERESTS, AND ORGANIZATIONS REPRESENTING THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. INFORMANTS WERE INVITED TO ATTEND A DATA PRESENTATION AND GIVE FEEDBACK ON THEIR PRIORITY FOCUS AREAS BASED ON THE 2019-2024 NEW YORK STATE PREVENTION AGENDA ACTION PLANS. THOSE KEY INFORMANTS WHO COULD NOT ATTEND IN PERSON WERE PROVIDED THE INFORMATION ELECTRONICALLY AND ASKED TO FILL OUT A SHORT SURVEY. IN ADDITION TO THE KEY INFORMANT RESPONSES, THE ASSESSMENT INCLUDES QUANTITATIVE DATA COLLECTED BY FEDERAL, STATE, AND SPECIALIZED ORGANIZATIONS. THE BASSETT HEALTHCARE NETWORK POPULATION HEALTH AND VALUE-BASED INITIATIVES DEPARTMENT PARTNERED WITH OTSEGO COUNTY PUBLIC HEALTH, A.O. FOX HOSPITAL, AND MARY IMOGENE BASSETT MEDICAL CENTER TO DEVELOP A COMPREHENSIVE COMMUNITY NEEDS ASSESSMENT. THE PROCESS INCLUDED DATA COLLECTION FROM FEDERAL AND STATE DATABASES IN ADDITION TO SURVEYING THE BROAD INTERESTS OF THE COMMUNITY. THE SURVEYS, COMMUNITY ENGAGEMENT AND STAKEHOLDER ENGAGEMENT WERE OFFERED ELECTRONICALLY DURING THE DATES OF JUNE 29, 2022, TO AUGUST 6, 2022. THE LIST OF THOSE WHO RECEIVED THE SURVEY WAS COMPOSED OF FEEDBACK FROM THE BASSETT HEALTHCARE NETWORK, A.O. FOX HOSPITAL, MARY IMOGENE BASSETT MEDICAL CENTER, THE OTSEGO COUNTY PUBLIC HEALTH OFFICE, AND A NUMBER OF PERTINENT PARTNERS. THE INFORMATION COLLECTED REFLECTS THE CURRENT COUNTY STATUS AND PROBLEMS RELATED TO SIGNIFICANT HEALTH NEEDS OR SOCIAL DETERMINANTS OF HEALTH (SDOH). AFTER THE COLLECTION OF DATA WAS COMPLETE, THE COLLABORATION OF PARTNERS HELD A STAKEHOLDER FOCUS GROUP TO DISCUSS POTENTIAL INTERVENTIONS AND DECIDE WHAT AREAS SHOULD BE ADDRESSED IN THIS NYS PREVENTION AGENDA CYCLE 2022-2024. THE STAKEHOLDER FOCUS GROUP WAS HELD IN PERSON ON SEPTEMBER 14, 2022, AT THE MEADOWS OFFICE COMPLEX IN COOPERSTOWN, NY. BASED ON THE KEY INFORMATION COLLECTED, PRIORITIES WERE DEFINED, AND INTERVENTIONS DEVELOPED.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 6a Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - AURELIA OSBORN FOX MEMORIAL HOSPITAL. MARY IMOGENE BASSETT HOSPITAL</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 6b Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - AURELIA OSBORN FOX MEMORIAL HOSPITAL. OTSEGO COUNTY DEPARTMENT OF HEALTH</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - AURELIA OSBORN FOX MEMORIAL HOSPITAL. THE ORGANIZATION ADDRESSED SIGNIFICANT, PRIORITIZED HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFICATION IN THE CHNA, PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY, AND PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITY. THE FOLLOWING PRIORITIES AND INTERVENTIONS WERE IDENTIFIED DURING 2022 AS PART OF THE CHNA DEVELOPMENT PROCESS. PRIORITY: PROMOTE A HEALTHY AND SAFE ENVIRONMENT PROVIDE SKILL-BUILDING CLASSES IN HOME MAINTENANCE AND UPKEEP; THE CAPSTONE OF THE CLASS IS TO PERFORM MAINTENANCE AND UPKEEP ON THE HOME OF AN ELDERLY INDIVIDUAL. PRIORITY: PREVENT CHRONIC DISEASE HEALTHY EATING AND FOOD SECURITY PROVIDE ACCESS TO FOUR TYPES OF HEALTHY FOOD CROPS IN THE WINTER AND SUMMER SEASONS INTERVENTIONS INCLUDE: - GREENHOUSE (HOOP HOUSE) INSTALLED AND MAINTAINED TO PROVIDE HEALTHY FOODS FURTHER INTO THE WINTER SEASON. - RECIPE CARDS DESCRIBING HOW TO PREPARE THE CROPS WILL BE DISTRIBUTED TO THE PUBLIC. PRIORITY: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS - PROVIDE A SUMMER DAY CAMP TARGETING FEMALES IN 6TH, 7TH, AND 8TH GRADE TO GIVE EXPOSURE TO EMERGENCY SERVICES CAREERS. BASSETT HEALTHCARE NETWORK, A.O FOX HOSPITAL, BASSETT MEDICAL CENTER, AND OTSEGO COUNTY DEPARTMENT OF HEALTH WILL PARTNER WITH LOCAL ORGANIZATIONS IN THE AREAS OF POLICE, FIRE, EMS, 911 DISPATCH, LIFEFLIGHT, SEARCH AND RESCUE, AND EMERGENCY ROOMS TO PROVIDE HANDS-ON EXPERIENCE IN THESE FIELDS. PARTICIPANTS WILL WALK AWAY WITH: - INCREASED HEALTH LITERACY - EXPOSURE TO VOLUNTEER OPPORTUNITIES - EXPOSURE TO EMERGENCY SERVICE CAREERS - TRAINING IN CPR, FIRST AID, AND AED USE PREVENT MENTAL AND SUBSTANCE USE DISORDERS PATIENTS ARRIVING IN BASSETT MEDICAL CENTER, AO FOX HOSPITAL, OR A COUNTY PRIMARY CARE CLINIC IN THE BASSETT HEALTHCARE NETWORK WHO HAS AN ADDICTION ARE TO BE REFERRED TO FORDO WITH IMMEDIATE CONNECTION IN THE FACILITY, OR INFORMATION IS TO BE SENT TO FORDO FOR FOLLOW-UP.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>10</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>AURELIA OSBORN FOX MEMORIAL HOSPITAL</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
            <CityNm>ONEONTA</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13820</ZIPCd>
          </USAddress>
          <FacilityTxt>NURSING HOME</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>CHILD AND ADOLESCENT HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
            <CityNm>ONEONTA</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13820</ZIPCd>
          </USAddress>
          <FacilityTxt>PEDIATRIC CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>ONEONTA FAMILY PRACTICE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
            <CityNm>ONEONTA</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13820</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY MEDICINE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FOXCARE WOMENS WELLNESS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
            <CityNm>ONEONTA</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13820</ZIPCd>
          </USAddress>
          <FacilityTxt>OB/GYN CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SUSQUEHANNA FAMILY PRACTICE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
            <CityNm>ONEONTA</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13820</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY MEDICINE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FOX INTERNAL MEDICINE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
            <CityNm>ONEONTA</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13820</ZIPCd>
          </USAddress>
          <FacilityTxt>INTERNAL MEDICINE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FOXCARE DENTAL</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1 NORTON AVENUE</AddressLine1Txt>
            <CityNm>ONEONTA</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13820</ZIPCd>
          </USAddress>
          <FacilityTxt>DENTAL CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SIDNEY PRIMARY CARE CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>59 RIVER STREET</AddressLine1Txt>
            <CityNm>SIDNEY</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13838</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY MEDICINE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>STAMFORD FAMILY PRACTICE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>32-34 MAIN STREET</AddressLine1Txt>
            <CityNm>STAMFORD</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>12167</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY MEDICINE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FOX TRI TOWN CAMPUS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>43 PEARL STREET WEST</AddressLine1Txt>
            <CityNm>SIDNEY</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13838</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT SERVICES</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>AURELIA OSBORN FOX MEMORIAL HOSPITAL'S COMPREHENSIVE THREE YEAR COMMUNITY SERVICE PLAN WAS SUMMARIZED IN AN ANNUAL COMMUNITY REPORT. PRINTED COPIES WERE AVAILABLE TO THE PUBLIC IN PATIENT WAITING ROOMS AND AT INFORMATION KIOSKS. THE REPORT IS ALSO POSTED ON THE BASSETT WEBSITE, WWW.BASSETT.ORG/LOCATIONS/AO-FOX-HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAID SHORTFALL IS INCLUDED IN THIS LINE IN THE AMOUNT OF $4,690,247. During 2024, THE HOSPITAL'S UNREIMBURSED MEDICAID WAS PARTIALLY OFFSET BY DIRECTED PAYMENT TEMPLATE (DPT) FUNDS RECEIVED THROUGH NEW YORK STATE'S HOSPITAL VITAL ACCESS PROVIDER ASSURANCE PROGRAM. THOSE FUNDS ARE INCLUDED IN THE DIRECT OFFSETTING REVENUE TOTAL REPORTED ON PART I LINE 7B COLUMN D.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 3c OTHER CRITERIA FOR FREE OR DISCOUNTED CARE</FormAndLineReferenceDesc>
        <ExplanationTxt>Underinsured is defined by NYS for FPL purposes as anyone who has insurance and is between 0-400% FPL. Underinsured individuals are required to show they have spent 10% of their annual income on eligible medical expenses. Uninsured patients automatically qualify if they are between 0-400% FPL. Patients are eligible for financial assistance through the hospital's program for emergency services for residents of New York State, and for all other services, if they reside within the hospital's primary service area.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 6a Community benefit report prepared by related organization</FormAndLineReferenceDesc>
        <ExplanationTxt>BASSETT HEALTHCARE NETWORK</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COST METHODOLOGY USED FOR TABLE 7 IS THE RATIO OF COST TO CHARGES FROM 12/31/2024 MEDICARE FORM 2552. THE BAD DEBT EXPENSE OF $2,276,792 WAS SUBTRACTED FROM THE TOTAL EXPENSE VALUES USED TO CALCULATE THE PERCENTAGES IN PART 1, LINE 7, COLUMN F.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE DUE TO THE ADOPTION OF ASU NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENTS. RATHER IT IS TREATED AS A NON-VOLUNTARY PRICE CONCESSION. THE BAD DEBT EXPENSE FOR 2024 WAS $2,276,792.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>CHARITY CARE FOOTNOTE (3) FROM THE CONSOLIDATED FINANCIALS THE COST OF CHARITY CARE PROVIDED IS DETERMINED BASED ON THE APPLICATION OF A COST TO GROSS CHARGE RATIO TO THE TOTAL CHARITY CARE CHARGES FOREGONE. INCLUDED IN NET PATIENT SERVICE REVENUE ARE AMOUNTS PAID INTO AND RECEIVED FROM STATEWIDE UNCOMPENSATED CARE POOLS. THESE UNCOMPENSATED CARE POOLS ARE DESIGNED TO HELP OFFSET THE COST OF CHARITY CARE AND REIMBURSED MEDICAID SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 8 Community benefit &amp; methodology for determining medicare costs</FormAndLineReferenceDesc>
        <ExplanationTxt>WHEN MEDICARE PATIENTS PRESENT WE ARE AWARE THAT THERE IS A PREDETERMINED REIMBURSEMENT THAT IS BELOW OUR HOSPITAL'S COST. THE PORTION THAT WE ARE NOT REIMBURSED THEREFORE WOULD BE CONSIDERED A COMMUNITY BENEFIT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>IT IS A.O. FOX MEMORIAL HOSPITAL'S POLICY TO DELAY FINAL COLLECTION EFFORTS WHILE AN APPLICATION IS IN PROCESS UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. COLLECTION EFFORTS ARE NOT INITIATED UNTIL THE FINAL DETERMINATION OF ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16a FAP website</FormAndLineReferenceDesc>
        <ExplanationTxt>- AURELIA OSBORN FOX MEMORIAL HOSPITAL: Line 16a URL: http://www.bassett.org/patients-visitors/billing-insurance/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16b FAP Application website</FormAndLineReferenceDesc>
        <ExplanationTxt>- AURELIA OSBORN FOX MEMORIAL HOSPITAL: Line 16b URL: http://www.bassett.org/patients-visitors/billing-insurance/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16c FAP plain language summary website</FormAndLineReferenceDesc>
        <ExplanationTxt>- AURELIA OSBORN FOX MEMORIAL HOSPITAL: Line 16c URL: http://www.bassett.org/patients-visitors/billing-insurance/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2 Needs assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), A VARIETY OF DATA ARE USED REGULARLY TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY SERVED BY AO FOX HOSPITAL, INCLUDING DATA FROM PATIENT SATISFACTION SURVEYS, THE NYS DEPARTMENT OF HEALTH, AND THE NYS PREVENTION AGENDA, WHICH IDENTIFIED PRIORITY HEALTH INDICATORS TO BE USED BY NYS HOSPITALS, PROVIDERS, AND COUNTY HEALTH DEPARTMENTS IN ASSESSING AND SETTING LOCAL/REGIONAL PRIORITIES. THE PREVENTION AGENDA ALSO IDENTIFIES A COMMON SET OF HEALTHCARE PRIORITIES FROM WHICH HOSPITALS AND COUNTY HEALTH DEPARTMENTS IN NEW YORK STATE ARE EXPECTED TO CHOOSE WHEN DEVELOPING IMPLEMENTATION STRATEGIES FOR ADDRESSING COMMUNITY HEALTHCARE NEEDS. COMMUNITY PARTNERS INVOLVED IN ASSESSING COMMUNITY HEALTH NEEDS IN ONE COUNTY INCLUDED: OTSEGO COUNTY HEALTH DEPARTMENT; BASSETT PRIMARY CARE GROUP; COMMUNITY-BASED ORGANIZATIONS; AND OTSEGO COUNTY SOCIAL SERVICE, MENTAL HEALTH, YOUTH AND AGING AGENCIES. AO FOX HOSPITAL CONTRACTS WITH PRESS GANEY TO OBTAIN BENCHMARKING DATA ON PATIENT SATISFACTION IN ORDER TO ASSESS HOW THE HOSPITAL IS PERCEIVED TO BE MEETING PATIENT NEEDS. DATA FROM ONGOING MAIL SURVEYS CARRIED OUT AMONG A STATISTICALLY SIGNIFICANT RANDOM SAMPLE OF INPATIENTS AND OUTPATIENTS IS USED TO IMPROVE PATIENT CARE AND INFORM OFFICIAL QUALITY IMPROVEMENT ACTIVITIES. DATA COLLECTED FROM THIS INSTRUMENT INCLUDE A COMPREHENSIVE OVERVIEW OF KEY, EVIDENCE-BASED QUALITY INDICATORS -- FROM TIMELINESS OF CARE TO COMMUNICATIONS, PATIENT SAFETY, DISCHARGE INSTRUCTION, MEDICATION ISSUES, AND MORE. THE HOSPITAL RECEIVES REPORTS QUARTERLY. THE HOSPITAL ALSO UTILIZES INFORMATION FROM THE STANDARDIZED, PUBLICLY REPORTED HCAHPS (HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS) SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. THE HCAHPS REPORTING AND SURVEY ARE REQUIRED BY THE CENTER FOR MEDICARE SERVICES (CMS) TO ALLOW STANDARD, OBJECTIVE, VALID COMPARISONS TO BE MADE ACROSS HOSPITALS NATIONALLY, REGIONALLY, AND LOCALLY REPORTS ARE RECEIVED QUARTERLY AND HAVE BEEN PUBLISHED NATIONALLY ON THE CMS AND NYS DEPARTMENT OF HEALTH WEBSITES. THE SURVEY METHODOLOGY AND RESULTS ARE IN THE PUBLIC DOMAIN. (WWW.HCAHPSONLINE.ORG). ADDITIONALLY, THE HOSPITAL'S NEEDS ASSESSMENT ACTIVITIES ARE INFORMED BY INITIATIVES AND STUDIES CARRIED OUT BY THE BASSETT HEALTHCARE NETWORK RESEARCH INSTITUTE, INCLUDING THE UPSTATE HEALTH AND WELLNESS STUDY 2009. THIS PROJECT ASSESSED HEALTH INDICATORS, IDENTIFIED RURAL-URBAN HEALTH DISPARITIES, AND PROVIDED BASELINE DATA TO ASSIST COMMUNITY HEALTHCARE PLANNING IN THE RURAL REGION SERVED BY BASSETT, INCLUDING SCHOHARIE COUNTY. IT IS A COLLABORATIVE EFFORT BETWEEN THE RESEARCH INSTITUTE, COUNTY HEALTH DEPARTMENTS, AND REGIONAL COMMUNITY SERVICES ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3 Patient education of eligibility for assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE A MAJOR COMPONENT OF AURELIA OSBORN FOX MEMORIAL HOSPITAL'S COMMUNITY SERVICES PROGRAM IS TO ACTIVELY IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY CARE. THE PROCESS BEGINS WITH AN ORGANIZATIONAL POLICY AND PROCEDURE THAT DEFINES THE PROGRAM AND SERVES AS AN EDUCATION TOOL FOR ALL BASSETT EMPLOYEES. THE POLICY IS UPDATED ANNUALLY, DISTRIBUTED TO KEY PERSONNEL AND POSTED IN THE ONLINE POLICY AND PROCEDURE MANUAL THAT IS ACCESSIBLE TO ALL EMPLOYEES. THE PROGRAM IS SUPPORTED BY A FOUR PAGE PLAIN LANGUAGE BROCHURE THAT INCLUDES AN APPLICATION. BROCHURES ARE PROMINENTLY DISPLAYED AND AVAILABLE AT ALL FACILITIES AND ALL CLINIC LOCATIONS. CLINICAL AND SUPPORT STAFF ARE MADE AWARE OF THE PROGRAM AND ABLE TO DIRECT PATIENTS TO SPECIALISTS WHO CAN ASSIST IN THE APPLICATION PROCESS. ALL PATIENTS WHO ARE REGISTERED AS SELF-PAY ARE PROVIDED A BROCHURE EITHER IN PERSON OR BY MAIL. PATIENTS WHO ARE IN THE HOSPITAL RECEIVE INFORMATION AS PART OF A PERSONAL VISIT GEARED TO HELP THE PATIENT NAVIGATE FINANCIAL ASSISTANCE INCLUDING, BUT NOT LIMITED TO, THE COMMUNITY SERVICES PROGRAM. GOVERNMENT PROGRAM OPPORTUNITIES ARE ALSO REFERENCED AND A DIRECTORY OF LOCAL SOCIAL SERVICES AGENCIES IS PROVIDED BASED ON THE PATIENT'S COUNTY OF RESIDENCE. REFERRAL TO AN ONSITE MEDICAID EXAMINER IS AVAILABLE. A LISTING OF ALL SELF-PAY ACCOUNTS IS PRODUCED AND REVIEWED DAILY TO INSURE THAT A COMMUNITY SERVICES BROCHURE HAS BEEN PROVIDED. THE SELF-PAY BILLING OFFICE IDENTIFIES PATIENTS DURING THE BILLING AND COLLECTIONS PROCESS THAT MAY REQUIRE ADDITIONAL HELP UNDERSTANDING THE PROGRAM. SELF-PAY ACCOUNTS FOR PATIENTS WHO HAVE BEEN APPROVED FOR COMMUNITY SERVICES WITHIN THE PRIOR 120 DAYS ARE AUTOMATICALLY INCLUDED WITH THE PRIOR APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4 Community information</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY INFORMATION AURELIA OSBORN FOX MEMORIAL HOSPITAL IS PART OF THE BASSETT HEALTHCARE NETWORK THAT PROVIDES HEALTH SERVICES IN MORE THAN 20 COMMUNITIES SPANNING 5,600 SQUARE MILES AND SEVEN COUNTIES. THE NETWORK FOCUSES ITS COMMUNITY SERVICES PROGRAMS IN THE COUNTIES WHERE THE SIX AFFILIATED HOSPITALS AND GREATEST PATIENT POPULATIONS ARE LOCATED. IN THE SEVEN COUNTY REGIONS, THE MEDIAN HOUSEHOLD INCOME RANGES BETWEEN $43,000 AND $48,000. 13-18 % OF THE COMMUNITY RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY GUIDELINES. THE FOLLOWING AREAS HAVE BEEN FEDERALLY DESIGNATED AS BEING MEDICALLY UNDERSERVED: A) HERKIMER COUNTY B) FULTON COUNTY, TOWN OF OPPENHEIM C) MONTGOMERY COUNTY, CITY OF AMSTERDAM D) OTSEGO COUNTY, NORTH OTSEGO SERVICE AREA, TOWN OF PLAINFIELD, TOWN OF DECATUR E) DELAWARE COUNTY, TOWNS OF DEPOSIT, COLCHESTER, MIDDLETOWN</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5 Promotion of community health</FormAndLineReferenceDesc>
        <ExplanationTxt>A MAJORITY OF A.O. FOX HOSPITAL'S BOARD OF TRUSTEES IS COMPRISED OF COMMUNITY VOLUNTEERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. AS A NOT-FOR-PROFIT HOSPITAL, A.O. FOX REINVESTS SURPLUS FUNDS TOWARD EQUIPMENT/TECHNOLOGY IMPROVEMENTS IN PATIENT CARE AND PATIENT SAFETY, AS WELL AS INFRASTRUCTURE UPGRADES MANDATED BY JOINT COMMISSION AND GOVERNMENT/REGULATORY REQUIREMENTS AND DEEMED NECESSARY TO KEEP THE HOSPITAL ACCREDITED AND ABLE TO CONTINUE SERVING THE HEALTH NEEDS. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS WHO ARE EMPLOYED BY BASSETT MEDICAL CENTER. THE HOSPITAL OPERATES AN EMERGENCY ROOM WHICH IS OPEN TO ALL, REGARDLESS OF ABILITY TO PAY. COMMUNITY HEALTH IMPROVEMENT AND EDUCATION ARE KEY STRATEGIES IN THE HOSPITAL'S PLAN OF RESPONSE TO THE COMMUNITY'S HEALTH PRIORITIES AND NEEDS. THE HOSPITAL'S INITIATIVES ARE LARGELY GUIDED BY THE NEW YORK STATE DEPARTMENT OF HEALTH PUBLIC HEALTH PREVENTION AGENDA. THEY ARE CHOSEN AND COORDINATED IN CLOSE COLLABORATION WITH THE OTSEGO COUNTY DEPARTMENT OF HEALTH AND BASSETT HEALTHCARE NETWORK, IN PARTICULAR REFLECTING THE COUNTY'S HEALTH ASSESSMENT AND THE BASSETT HEALTH AND WELLNESS SURVEY. STRATEGIES FOCUS ON ACCESS, EDUCATION AND AWARENESS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 6 Affiliated health care system</FormAndLineReferenceDesc>
        <ExplanationTxt>AURELIA OSBORN FOX MEMORIAL HOSPITAL IS PART OF THE BASSETT HEALTHCARE NETWORK THAT PROVIDES HEALTH SERVICES IN MORE THAN 20 COMMUNITIES SPANNING 5,600 SQUARE MILES AND SEVEN COUNTIES. THE NETWORK FOCUSES ITS COMMUNITY SERVICES PROGRAMS IN THE COUNTIES WHERE THE SIX AFFILIATED HOSPITALS AND GREATEST PATIENT POPULATIONS ARE LOCATED. OTSEGO COUNTY POPULATION 60,094, DELAWARE COUNTY - POPULATION 45,001, HERKIMER COUNTY POPULATION 62,240, SCHOHARIE COUNTY - POPULATION 31,420 (ACCORDING TO THE 2017 U.S. CENSUS ESTIMATES). A) BASSETT - AN ACUTE CARE INPATIENT TEACHING FACILITY, AN OUTPATIENT PRIMARY AND SPECIALTY CARE CENTER, A REGIONAL NETWORK OF 29 COMMUNITY BASED OUTPATIENT HEALTH CENTERS, 20 SCHOOL BASED HEALTH CENTERS, TWO AMBULATORY SURGERY CENTERS AND A FULLY SALARIED MEDICAL STAFF IN COOPERSTOWN, OTSEGO COUNTY B) O'CONNOR HOSPITAL - CRITICAL ACCESS HOSPITAL IN DELHI, DELAWARE COUNTY C) COBLESKILL REGIONAL HOSPITAL - ACUTE CARE FACILITY IN COBLESKILL, SCHOHARIE COUNTY D) LITTLE FALLS HOSPITAL - CRITICAL ACCESS HOSPITAL IN LITTLE FALLS, HERKIMER COUNTY E) A.O. FOX MEMORIAL HOSPITAL - ACUTE CARE FACILITY IN ONEONTA, OTSEGO COUNTY F) VALLEY HEALTH SERVICES - RESIDENTIAL HEALTH CARE AND REHABILITATION FACILITY G) AT HOME CARE - CERTIFIED HOME CARE AGENCY H) FIRST COMMUNITY CARE OF BASSETT - MEDICAL SUPPLY COMPANY ALL THE ABOVE (A-I) MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS SEVEN COUNTY REGION IN CENTRAL NEW YORK.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 7 State filing of community benefit report</FormAndLineReferenceDesc>
        <ExplanationTxt>NY</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="24020961" softwareVersionNum="2024v5.1">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>true</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Tommy Ibrahim MD</PersonNm>
        <TitleTxt>Former President</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>411723</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>12888</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>424611</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Staci Thompson</PersonNm>
        <TitleTxt>BHN President and CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>826810</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>40000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>12117</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>878927</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Craig Faerber</PersonNm>
        <TitleTxt>Interim Network CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>524460</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>524460</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Joan MacDonald</PersonNm>
        <TitleTxt>VP Operations/CNO</TitleTxt>
        <BaseCompensationFilingOrgAmt>217647</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10816</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>529</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>228992</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dan Croft MD</PersonNm>
        <TitleTxt>Hospital Vice President Medical Affairs</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>362989</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>24728</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10448</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>398165</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Maia Decker</PersonNm>
        <TitleTxt>Pharmacy Inpatient Manager</TitleTxt>
        <BaseCompensationFilingOrgAmt>172914</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13659</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10139</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>196712</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Benjamin Wood</PersonNm>
        <TitleTxt>Clin Informatics Pharm</TitleTxt>
        <BaseCompensationFilingOrgAmt>163385</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9933</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7292</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>180610</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Margaret Wikoff</PersonNm>
        <TitleTxt>Nurse Manager - Nursing</TitleTxt>
        <BaseCompensationFilingOrgAmt>159275</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12285</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>5318</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>176878</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kyle Marks</PersonNm>
        <TitleTxt>Pharmacist II</TitleTxt>
        <BaseCompensationFilingOrgAmt>159840</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10177</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2450</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>172467</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Ann Skinner</PersonNm>
        <TitleTxt>CT Tech II</TitleTxt>
        <BaseCompensationFilingOrgAmt>160868</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8441</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2068</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>171377</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MARY IMOGENE BASSETT HOSPITAL (DBA BASSETT MEDICAL CENTER) PROVIDES THE COMPENSATION FOR THE PRESIDENTS OF O'CONNOR HOSPITAL, A.O. FOX MEMORIAL HOSPITAL, COBLESKILL REGIONAL HOSPITAL, AND LITTLE FALLS HOSPITAL. BASSETT MEDICAL CENTER USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR SAID INDIVIDUALS: A) COMPENSATION COMMITTEE, B) INDEPENDENT COMPENSATION CONSULTANT, C) WRITTEN EMPLOYMENT CONTRACT, D) COMPENSATION SURVEY OR STUDY AND, E) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4a Severance or change-of-control payment</FormAndLineReferenceDesc>
        <ExplanationTxt>TOMMY IBRAHIM, MD received a severance payment in the amount of $166,325 and PTO payout in the amount of $245,398. These amounts are included in the total reported in column B(iii).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 7 Non-fixed payments</FormAndLineReferenceDesc>
        <ExplanationTxt>NON-FIXED PAYMENTS ARE MADE BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE OFFICERS AND OTHER EMPLOYEES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="24020961" softwareVersionNum="2024v5.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part I, Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS 67-BED HOSPITAL PROVIDES EMERGENCY SERVICES AND COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES, INCLUDING CARDIOLOGY, CANCER SERVICES, ORTHOPEDIC SURGERY AND REHAB, SPINAL SURGERY, PULMONARY MEDICINE, IMAGING SERVICES, AND A SLEEP DISORDERS CENTER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS 67-BED HOSPITAL PROVIDES EMERGENCY SERVICES AND COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES, INCLUDING CARDIOLOGY, CANCER SERVICES, ORTHOPEDIC SURGERY AND REHAB, SPINAL SURGERY, PULMONARY MEDICINE, IMAGING SERVICES, AND A SLEEP DISORDERS CENTER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>BASSETT HEALTHCARE NETWORK IS THE SOLE MEMBER OF A.O. FOX MEMORIAL HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>BASSETT HEALTHCARE NETWORK IS THE PARENT AND SOLE MEMBER TO EACH OF THE FOLLOWING RELATED PARTIES: FRIENDS OF BASSETT, AURELIA OSBORN FOX MEMORIAL HOSPITAL, BASSETT HOSPITAL OF SCHOHARIE COUNTY, LITTLE FALLS HOSPITAL, O'CONNOR HOSPITAL, TEMPLETON FOUNDATION, VALLEY HEALTH SERVICES, VALLEY RESIDENTIAL SERVICES, AND THE MARY IMOGENE BASSETT HOSPITAL. AS PARENT AND SOLE MEMBER, BASSETT HEATHCARE NETWORK HAS THE RIGHT TO APPONT AND REMOVE MEMBERS OF THE GOVERNING BOARDS, INCLUDING, BUT NOT LIMITED TO, APPROVAL OF OPERATING AND CAPITAL BUDGETS, CERTAIN CAPITAL EXPENDITURES, INDEBTEDNESS NOT CONTAINED IN THE APPROVED BUDGETS, SUBSTANTIVE CHANGES IN CLINICAL PROGRAMS, MERGERS, CONSOLIDATIONS, LIQUIDATIONS AND DISSOLUTIONS INVOLVING ITS SUBSIDIARIES AND CERTIFICATE OF NEED APPLICATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE DISCLOSURE FOR PART VI, SECTION A, LINE 7A.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990S ARE PROVIDED TO THE BOARD BEFORE FILING. IF THERE ARE ANY QUESTIONS OR CONCERNS, THEY CAN RAISE IT WITH THE BOARD, CEO AND/OR CFO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY HOSPITAL ADMINISTRATION AND IF NECESSARY ARE REFERRED TO THE BOARD EXECUTIVE COMMITTEE TO BE HANDLED APPROPRIATELY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PRESIDENT'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE PRESIDENT'S WORKPLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE OVERSEEN BY THE NETWORK LEADERSHIP AND REVIEWABLE BY THE BOARD. THE PRESIDENT'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTATION, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. SOME INFORMATION IS ALSO AVAILABLE THROUGH THE DEPARTMENT OF HEALTH. THE DOH REQUIRES THE INFORMATION FOR PUBLIC AVAILABILITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>AGENCY - Total Expense: 7124792, Program Service Expense: 7107860, Management and General Expenses: 0, Fundraising Expenses: 16932; SERVICE CONTRACTS - Total Expense: 3472682, Program Service Expense: 3472682, Management and General Expenses: 0, Fundraising Expenses: 0; CONTRACTED OUTSIDE SVC - Total Expense: 9430115, Program Service Expense: 9430115, Management and General Expenses: , Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>POST RETIREMENT ADJUSTMENTS - 211995; Total - 211995;</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="24020961" softwareVersionNum="2024v5.1">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Bassett Healthcare Network</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>One Atwell Road</AddressLine1Txt>
          <CityNm>Cooperstown</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13326</ZIPCd>
        </USAddress>
        <EIN>133218680</EIN>
        <PrimaryActivitiesTxt>Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>None</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Friends of Bassett</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>One Atwell Road</AddressLine1Txt>
          <CityNm>Cooperstown</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13326</ZIPCd>
        </USAddress>
        <EIN>237041610</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Mary Imogene Bassett Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>One Atwell Road</AddressLine1Txt>
          <CityNm>Cooperstown</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13326</ZIPCd>
        </USAddress>
        <EIN>135596796</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Bassett Hospital Schoharie County</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>178 Grandview Drive</AddressLine1Txt>
          <CityNm>Cobleskill</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>12043</ZIPCd>
        </USAddress>
        <EIN>141772971</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Little Falls Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>140 Burwell Street</AddressLine1Txt>
          <CityNm>Little Falls</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13365</ZIPCd>
        </USAddress>
        <EIN>150533578</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>O'Connor Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>460 Andes Road</AddressLine1Txt>
          <CityNm>Delhi</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13753</ZIPCd>
        </USAddress>
        <EIN>161540394</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Templeton Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>One Atwell Road</AddressLine1Txt>
          <CityNm>Cooperstown</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13326</ZIPCd>
        </USAddress>
        <EIN>133317084</EIN>
        <PrimaryActivitiesTxt>Landlord</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Valley Health Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>690 West German Street</AddressLine1Txt>
          <CityNm>Herkimer</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13350</ZIPCd>
        </USAddress>
        <EIN>222511614</EIN>
        <PrimaryActivitiesTxt>Elder Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Valley Residential Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>690 West German Street</AddressLine1Txt>
          <CityNm>Herkimer</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13350</ZIPCd>
        </USAddress>
        <EIN>463703838</EIN>
        <PrimaryActivitiesTxt>Elder Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Bassett PPS LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>618 State Highway 7</AddressLine1Txt>
          <CityNm>Oneonta</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13820</ZIPCd>
        </USAddress>
        <EIN>811749905</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>At Home Care Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>25 Main Street</AddressLine1Txt>
          <CityNm>Oneonta</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13820</ZIPCd>
        </USAddress>
        <EIN>161287069</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BHN</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>At Home Care Partners Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>25 Main Street</AddressLine1Txt>
          <CityNm>Oneonta</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13820</ZIPCd>
        </USAddress>
        <EIN>562397098</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>AHC Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>First Community Care of Bassett</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>60 Northpoint Parkway</AddressLine1Txt>
          <CityNm>Amherst</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14228</ZIPCd>
        </USAddress>
        <EIN>161504464</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>N/A</PredominantIncomeTypeTxt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Stamford Professional Associates</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Norton Avenue</AddressLine1Txt>
          <CityNm>Oneonta</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13820</ZIPCd>
        </USAddress>
        <EIN>161322304</EIN>
        <PrimaryActivitiesTxt>Rental</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>N/A</PredominantIncomeTypeTxt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Catskill Care Enterprises</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Norton Avenue</AddressLine1Txt>
          <CityNm>Oneonta</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13820</ZIPCd>
        </USAddress>
        <EIN>161236590</EIN>
        <PrimaryActivitiesTxt>Retail Pharmacy &amp; Fitness Center</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>AO Fox</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corporation</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <OwnershipPct>1</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Leatherstocking Physicians PC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>One Atwell Road</AddressLine1Txt>
          <CityNm>Cooperstown</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13326</ZIPCd>
        </USAddress>
        <EIN>364864562</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corporation</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>true</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>true</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Stamford Professional Associates</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>60860</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>