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        <TitleTxt>CEO (START 6/24)</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>176737</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>141470</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>52504</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAWN GERZ</PersonNm>
        <TitleTxt>CNO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>151202</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24037</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES A GILMAN</PersonNm>
        <TitleTxt>PHF SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMIE MCKENZIE</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>135139</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41997</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAVITHA BHATIA MD</PersonNm>
        <TitleTxt>PHF PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEVE ALEMAN</PersonNm>
        <TitleTxt>PHF CFO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>8.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JESSE SHILOT</PersonNm>
        <TitleTxt>PHARMACIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>132171</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29145</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NICHOLAS PETRUSKA</PersonNm>
        <TitleTxt>PHARMACIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>136438</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17572</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERESA PASCO</PersonNm>
        <TitleTxt>REGIONAL DIRECTOR OF HUMAN RESOURCES</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>142067</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43722</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM SMITH</PersonNm>
        <TitleTxt>DIRECTOR OF PHARMACY</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>155305</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>50034</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN KNALLAY</PersonNm>
        <TitleTxt>IT DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>120751</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21660</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1355726</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>1205020</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>389703</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>18</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PRIME HEALTHCARE MANAGEMENT II INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3300 E GUASTI ROAD 3RD FL</AddressLine1Txt>
            <CityNm>ONTARIO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>91761</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MANAGEMENT SERVICES</ServicesDesc>
        <CompensationAmt>4997393</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JONES DAY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3161 MICHELSON DRIVE SUITE 800</AddressLine1Txt>
            <CityNm>IRVINE</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92612</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LEGAL FEES</ServicesDesc>
        <CompensationAmt>1153187</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BIO MED SERVICES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3300 E GUASTI ROAD 3RD FL</AddressLine1Txt>
            <CityNm>ONTARIO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>91761</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MATERIALS MANAGEMENT</ServicesDesc>
        <CompensationAmt>1074962</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PRIMERA MEDICAL TECHNOLOGIES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <ForeignAddress>
            <AddressLine1Txt>ONE CO-WORK 2ND FL</AddressLine1Txt>
            <CityNm>KARNATAKA</CityNm>
            <ProvinceOrStateNm>KARNATAKA</ProvinceOrStateNm>
            <CountryCd>IN</CountryCd>
            <ForeignPostalCd>560034</ForeignPostalCd>
          </ForeignAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL CODING SERVICES</ServicesDesc>
        <CompensationAmt>840720</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>EAST LIVERPOOL ANESTHESIA PROFESSIONALS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5761 PINTAIL CT</AddressLine1Txt>
            <CityNm>WESTERVILLE</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>43082</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ANESTHESIA SERVICES</ServicesDesc>
        <CompensationAmt>801415</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>45</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>OUTPATIENT REVENUE</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>49837000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>49837000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>INPATIENT REVENUE</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>33452876</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>33452876</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RENTAL INCOME FROM AFF</Desc>
        <BusinessCd>531120</BusinessCd>
        <TotalRevenueColumnAmt>64653</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>64653</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>83354529</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>269840</TotalRevenueColumnAmt>
        <ExclusionAmt>269840</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER OPERATING REVENU</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>773965</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>773965</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAFETERIA SALES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>203504</TotalRevenueColumnAmt>
        <ExclusionAmt>203504</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER NON-OPERATING RE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>131686</TotalRevenueColumnAmt>
        <ExclusionAmt>131686</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>39019</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39019</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>1148174</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>84772543</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>84167513</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>605030</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>31461</TotalAmt>
        <ProgramServicesAmt>31461</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>771124</TotalAmt>
        <ProgramServicesAmt>462674</ProgramServicesAmt>
        <ManagementAndGeneralAmt>308450</ManagementAndGeneralAmt>
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      <OtherSalariesAndWagesGrp>
        <TotalAmt>26611640</TotalAmt>
        <ProgramServicesAmt>15966984</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10644656</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>349584</TotalAmt>
        <ProgramServicesAmt>349584</ProgramServicesAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>5134787</TotalAmt>
        <ProgramServicesAmt>5134787</ProgramServicesAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>2116070</TotalAmt>
        <ProgramServicesAmt>1269641</ProgramServicesAmt>
        <ManagementAndGeneralAmt>846429</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>4997393</TotalAmt>
        <ManagementAndGeneralAmt>4997393</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>1715235</TotalAmt>
        <ManagementAndGeneralAmt>1715235</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>84395</TotalAmt>
        <ManagementAndGeneralAmt>84395</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>12665525</TotalAmt>
        <ProgramServicesAmt>7599310</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5066215</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>122480</TotalAmt>
        <ProgramServicesAmt>73488</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48992</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
        <TotalAmt>340504</TotalAmt>
        <ProgramServicesAmt>204302</ProgramServicesAmt>
        <ManagementAndGeneralAmt>136202</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
        <TotalAmt>89981</TotalAmt>
        <ProgramServicesAmt>89981</ProgramServicesAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>2288441</TotalAmt>
        <ProgramServicesAmt>2288441</ProgramServicesAmt>
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      <TravelGrp>
        <TotalAmt>145659</TotalAmt>
        <ProgramServicesAmt>87395</ProgramServicesAmt>
        <ManagementAndGeneralAmt>58264</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>33841</TotalAmt>
        <ProgramServicesAmt>33841</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1778133</TotalAmt>
        <ProgramServicesAmt>1778133</ProgramServicesAmt>
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      <InsuranceGrp>
        <TotalAmt>1155502</TotalAmt>
        <ProgramServicesAmt>1155502</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>5816047</TotalAmt>
        <ProgramServicesAmt>5816047</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>HOSPITAL FEE PROGRAM</Desc>
        <TotalAmt>2518265</TotalAmt>
        <ProgramServicesAmt>2518265</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>1615773</TotalAmt>
        <ProgramServicesAmt>969463</ProgramServicesAmt>
        <ManagementAndGeneralAmt>646310</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BILLABLE SUPPLIES</Desc>
        <TotalAmt>767297</TotalAmt>
        <ProgramServicesAmt>460378</ProgramServicesAmt>
        <ManagementAndGeneralAmt>306919</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>1502414</TotalAmt>
        <ProgramServicesAmt>1502414</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>72651551</TotalAmt>
        <ProgramServicesAmt>47792091</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24859460</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <SavingsAndTempCashInvstGrp>
        <BOYAmt>11844753</BOYAmt>
        <EOYAmt>6804380</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
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      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>11661544</BOYAmt>
        <EOYAmt>8630525</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>978955</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>425647</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>30176085</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>19121239</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>11711221</BOYAmt>
        <EOYAmt>11054846</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>2301369</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>727222</BOYAmt>
        <EOYAmt>624555</EOYAmt>
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      <OtherAssetsTotalGrp>
        <BOYAmt>105051336</BOYAmt>
        <EOYAmt>125792192</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>145492269</BOYAmt>
        <EOYAmt>156612469</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2952050</BOYAmt>
        <EOYAmt>3302393</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>5166</BOYAmt>
        <EOYAmt>9805</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>4874573</BOYAmt>
        <EOYAmt>3518799</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>7831789</BOYAmt>
        <EOYAmt>6830997</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>137660480</BOYAmt>
        <EOYAmt>149781472</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>137660480</BOYAmt>
        <EOYAmt>149781472</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>145492269</BOYAmt>
        <EOYAmt>156612469</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>12120992</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
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        <OtherCostOrOtherBasisAmt>918703</OtherCostOrOtherBasisAmt>
        <BookValueAmt>918703</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>14497001</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>7972402</DepreciationAmt>
        <BookValueAmt>6524599</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>262560</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>258008</DepreciationAmt>
        <BookValueAmt>4552</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>13215287</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>9679262</DepreciationAmt>
        <BookValueAmt>3536025</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>1282534</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1211567</DepreciationAmt>
        <BookValueAmt>70967</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>11054846</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>CONSTRUCTION IN PROCESS</Desc>
        <BookValueAmt>392326</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>ASSETS WHOSE USE IS LIMITED</Desc>
        <BookValueAmt>183921</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT-OF-USE ASSETS - OPERATING</Desc>
        <BookValueAmt>294723</BookValueAmt>
      </OtherAssetsOrgGrp>
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        <Desc>DUE FROM AFFILIATES</Desc>
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        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>PHF AND ITS NOT-FOR-PROFIT CORPORATE AFFILIATES ARE RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAXATION ON REVENUE EARNED IN ACTIVITIES FURTHERING THEIR TAX-EXEMPT PURPOSES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. REVENUE EARNED FROM UNRELATED ACTIVITIES DOES NOT RESULT IN A MATERIAL TAX LIABILITY. ACCORDINGLY, NO PROVISION HAS BEEN RECORDED FOR INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE AFFILIATES THAT PERFORM THE UNRELATED ACTIVITIES ARE SINGLE-MEMBER LIMITED LIABILITY COMPANIES WHOLLY OWNED BY PHF AND ARE DISREGARDED AS SEPARATE FROM PHF FOR FEDERAL INCOME TAX PURPOSES.</ExplanationTxt>
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          <BusinessNameLine1Txt>EAST LIVERPOOL CITY HOSPITAL</BusinessNameLine1Txt>
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        <CommunityDemographicsInd>X</CommunityDemographicsInd>
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        <HowDataObtainedInd>X</HowDataObtainedInd>
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        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
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        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>HTTP://WWW.ELCH.ORG/ABOUT-US/COMMUNITY-HEALTH/</OwnWebsiteURLTxt>
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        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>22</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
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        <FPGFamilyIncmLmtFreeCarePct>350.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>450.000000000000</FPGFamilyIncmLmtDscntCarePct>
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        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
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        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>HTTP://ELCH.ORG/PATIENTS-VISITORS/INSURANCE-FINANCIAL-INFO/</FAPAvailableOnWebsiteURLTxt>
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        <FAPAppAvailableOnWebsiteURLTxt>HTTP://ELCH.ORG/PATIENTS-VISITORS/INSURANCE-FINANCIAL-INFO/</FAPAppAvailableOnWebsiteURLTxt>
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        <FAPSummaryOnWebsiteURLTxt>HTTP://ELCH.ORG/PATIENTS-VISITORS/INSURANCE-FINANCIAL-INFO/</FAPSummaryOnWebsiteURLTxt>
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        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
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        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <ProspectiveMedicareMedicaidInd>X</ProspectiveMedicareMedicaidInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>EAST LIVERPOOL CITY HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: THE FY2022 CHNA FOR EAST LIVERPOOL CITY HOSPITAL WAS CONDUCTED FROM THE SUMMER OF 2021 THROUGH JUNE 2022 BY THE COLUMBIANA COUNTY HEALTH PARTNERS (CCHP) AND THEIR CONTRACTOR, THE LAKE COUNTY GENERAL HEALTH DISTRICT. THROUGH BOTH QUANTITATIVE AND QUALITATIVE RESEARCH METHODS AND COMMUNITY STAKEHOLDER FEEDBACK, PRIORITY HEALTH NEEDS WERE DETERMINED. COMMUNITY INPUT PLAYED AN INTEGRAL ROLE IN THE FY2022 CHNA. IN ASSESSING AND DETERMINING THE PRIORITY HEALTH NEEDS OF THE COMMUNITY, CCHP GATHERED THE PRIMARY DATA ELEMENTS FROM KEY STAKEHOLDERS AND FOCUS GROUPS, WHO ARE VIEWED AS EXPERTS IN A PARTICULAR FIELD RELATED TO THEIR BACKGROUND EXPERIENCE OR PROFESSIONAL POSITION; AND/OR THOSE WHO UNDERSTAND THE NEEDS OF A PARTICULAR COMMUNITY/GEOGRAPHIC REGION OR UNDERREPRESENTED GROUP, INCLUDING THE MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS. INPUT WAS COLLECTED THROUGH 599 WRITTEN COMMUNITY SURVEYS COMPLETED BY INDIVIDUALS REPRESENTING DIVERSE CONSTITUENT GROUPS AND 32 STAKEHOLDER AND FOCUS GROUP INTERVIEWS, REFLECTING INPUT FROM MORE THAN 106 PARTICIPANTS. KEY STAKEHOLDERS FROM THE COMMUNITY REPRESENTED THE FOLLOWING TYPES OF ORGANIZATIONS AND AGENCIES:- SCHOOL DISTRICTS AND YOUTH SERVICES- COMMUNITY RESOURCE CENTERS- HEALTH AND HUMAN SERVICE PROVIDERS- SENIOR SERVICES AND HOME HEALTH PROVIDERS- FAITH-BASED ORGANIZATIONS PROVIDING COMMUNITY ASSISTANCE- LOCAL GOVERNMENT OFFICIALS/COUNTY COMMISSIONERS- JUVENILE JUSTICE SYSTEM- MENTAL HEALTH AND RECOVERY SERVICE PROVIDERS- HISPANIC COMMUNITY MEMBERS- FOOD PANTRIES- HOSPITAL CASE MANAGERSSTAKEHOLDER INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED TO ASSESS AND COLLECT OPINIONS ON PERCEIVED HEALTH PRIORITIES WITH THE GOAL OF GARNERING FEEDBACK AND RECOMMENDATIONS TO IMPROVE HEALTH AND HEALTHCARE EXPERIENCE IN THE COMMUNITY.PARTICIPANTS PROVIDED INPUT ON THE FOLLOWING ISSUES: - FACTORS IMPACTING SOCIAL DETERMINANTS OF HEALTH AND COMMUNITY HEALTH STATUS SUCH AS POVERTY, DRUG ADDICTION, LACK OF TRANSPORTATION, EDUCATION/HEALTH LITERACY, LANGUAGE BARRIERS, ETC. - IMPORTANT HEALTH TOPICS AND PROPRIETIES TO ADDRESS AND PREVENT. - PROGRAMS AND RESOURCES AVAILABLE TO COMMUNITY MEMBERS. - OPPORTUNITIES TO INCREASE ACCESS TO HEALTH CARE RESOURCES.- HOW TO IMPROVE COMMUNITY SUPPORT. THE FOLLOWING CONTRIBUTED TO THE CHNA PROCESS AS COMMUNITY PARTNERS:ADAPT COALITIONAKRON CHILDREN'S HOSPITAL PEDIATRICS LISBON AND EAST LIVERPOOLCOLUMBIANA COUNTY BOARD OF DEVELOPMENTAL DISABILITIESCOLUMBIANA COUNTY MENTAL HEALTH &amp; RECOVERY SERVICES BOARDCOLUMBIANA COUNTY SUPERINTENDENTSGUATEMALAN RESIDENTSEAST LIVERPOOL CITY HOSPITAL INTERNAL/FAMILY MEDICINE AND SOCIAL WORKLISBON CAA HEALTH CENTER BOARD OF DIRECTORSPEER RESOURCE AND RECOVERY CENTERSALVATION ARMY SALEM CORPSSCHOOL NURSESSTUDENTS YOUTH MENTAL HEALTH - THE COUNSELING CENTER</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>EAST LIVERPOOL CITY HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6A: THE FY2022 CHNA WAS CONDUCTED BY CCHP. THE FOLLOWING HOSPITALS ARE A PART OF THE 2022 COLUMBIANA COUNTY HEALTH PARTNERS' COLLABORATIVE WORKGROUP. - EAST LIVERPOOL CITY HOSPITAL- AKRON CHILDREN'S HOSPITAL- SALEM REGIONAL MEDICAL CENTER</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>EAST LIVERPOOL CITY HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6B: THE FY2022 CHNA WAS CONDUCTED BY CCHP. THE FOLLOWING NON-HOSPITAL FACILITIES ARE A PART OF THE 2022 COLUMBIANA COUNTY HEALTH PARTNERS' COLLABORATIVE WORKGROUP. - EAST LIVERPOOL CITY HEALTH DISTRICT- COLUMBIANA COUNTY EDUCATIONAL SERVICE CENTER- COLUMBIANA COUNTY GENERAL HEALTH DISTRICT- FAMILY AND CHILDREN FIRST COUNCIL- COLUMBIANA COUNTY MENTAL HEALTH AND RECOVERY SERVICES BOARD- SALEM CITY HEALTH DEPARTMENT- COORDINATED ACTION AGENCY OF COLUMBIANA COUNTY- COORDINATED ACTION FOR SCHOOL HEALTH (CASH) COALITION- THE OHIO STATE UNIVERSITY - EXTENSION</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>EAST LIVERPOOL CITY HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: THE FY2022 CHNA WAS CONDUCTED TO BETTER UNDERSTAND THE PRIORITY HEALTH NEEDS OF THE COMMUNITY SERVED BY EAST LIVERPOOL CITY HOSPITAL. AS A RESULT, THE FOLLOWING FOUR PRIORITY HEALTH NEEDS WERE IDENTIFIED:1. CHRONIC DISEASE 2. MENTAL HEALTH/TRAUMA3. DRUG DEPENDENCY/ABUSE 4. OBESITY CHRONIC DISEASETHE GOAL IS TO REDUCE HEART DISEASE AND DIABETES. EAST LIVERPOOL CITY HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES:1. PERFORM HYPERTENSION SCREENINGS AND FOLLOW-UPS.2. PERFORM PRE-DIABETES SCREENINGS, TESTING AND REFERRAL TO DIABETES PREVENTION PROGRAM.3. HEART DISEASE EDUCATION THAT WILL FOCUS ON, BUT IS NOT LIMITED TO, MYOCARDIAL INFARCTION, MALE/FEMALE MORTALITY IN HEART DISEASE, HIGH BLOOD PRESSURE, AND HIGH CHOLESTEROL. 4. EVALUATE AND ASSESS CURRENT INTERNAL CARDIOVASCULAR ASSESSMENTS, SHARING RESULTS OF SUCH ASSESSMENTS WITH THEIR RESPECTIVE POPULATIONS INCLUDING LOCAL EMS AGENCIES, INCLUDING BUT NOT LIMITED TO COLLABORATIVE COMMUNITY EDUCATION FOR TARGETED PATIENT OUTREACH. MENTAL HEALTH/TRAUMATHE GOAL IS TO REDUCE ADVERSE CHILDHOOD EXPERIENCES (ACES). EAST LIVERPOOL CITY HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES:1. INITIATE AN INTIMATE PARTNER VIOLENCE SCREENING AND FOLLOW-UP PROGRAM, WITHIN EAST LIVERPOOL CITY HOSPITAL'S SERVICE AREA. 2. ENCOURAGE AND SUPPORT COLUMBIANA COUNTY HEALTH PARTNERS BY SUPPORTING MULTI-SYSTEMIC THERAPY FOR JUVENILE OFFENDERS. DRUG DEPENDENCY/ABUSETHE GOAL IS TO REDUCE DEATHS BY SUICIDE, INCREASE KNOWLEDGE AND IMPROVE COPING SKILLS. EAST LIVERPOOL CITY HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES:1. COLLABORATE WITH THE COMMUNITY TO EDUCATE AND IDENTIFY THE DISTRIBUTION OUTLETS OF NALOXONE. 2. HEALTH DEPARTMENTS TO ENCOURAGE FIRST RESPONDERS AND EMPLOYEES TO HAVE NALOXONE ON HAND. 3. INCREASE ORGANIZATION AWARENESS OF ANY AGENCY THAT HAS ACCESS AND CAN DISTRIBUTE NALOXONE THROUGH PROJECT DAWN.4. PARTICIPATE IN A PRESCRIPTION DRUG MONITORING PROGRAM FOR EVERY PATIENT THAT RECEIVES A CONTROLLED PRESCRIPTION. 5. LIMIT ACCESS TO PRESCRIPTION AND NON-PRESCRIPTION MEDICATIONS BY CONTINUING SUPPORT OF THE DEA'S MEDICATION TAKE BACK EVENTS AND DROP-OFF LOCKBOXES.OBESITYTHE GOAL IS TO IMPROVE DIETARY HABITS, INCREASE FRUIT AND VEGETABLE CONSUMPTION, REDUCE SWEETENED BEVERAGE CONSUMPTION AND IMPROVE WEIGHT STATUS.EAST LIVERPOOL CITY HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES:1. COORDINATE EFFORTS BETWEEN EAST LIVERPOOL CITY HOSPITAL AND OTHER COMMUNITY PROVIDERS TO INCREASE COMMUNITY OUTREACH AND EDUCATION ABOUT HEALTHY FOOD CHOICES.2. PROVIDE MINIMUM OF ONE COMMUNITY PRESENTATION THAT INCLUDES NUTRITION EDUCATION.3. DISTRIBUTE HEALTH RECIPES/NUTRITION INFORMATION AT MAJOR COMMUNITY EVENTS.4. BEGIN PREPARATIONS TO HOST A HEALTHY MEAL PREPARATION CLASS FOR VULNERABLE POPULATIONS.5. ENHANCE ACCESS TO SCHOOL-BASED PROGRAMS PROMOTING NUTRITION AND PHYSICAL ACTIVITY IN COLLABORATION WITH THE COORDINATED ACTION FOR SCHOOL HEALTH (CASH) COALITION THROUGH ANNUAL COMMUNITY BENEFIT GRANT FUNDING.6. IMPLEMENT A PROCESS FOR FOOD INSECURITY SCREENING AND REFERRAL. BUILDING UPON THE CURRENT CHNA AND IMPLEMENTATION STRATEGY, THE HOSPITAL DID THE FOLLOWING DURING FY'24 TO ADDRESS THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY:- DEA MEDICATION TAKE-BACK- OP EDUCATION ON NUTRITION FOR WEIGHT LOSS AND DIABETES- GLUCOSE SCREENINGS- DIABETIC SCREENINGS AND FOOT SCREENINGS- EYE SCREENINGS- POISON PREVENTION EDUCATION- ALCOHOL AWARENESS (OVERUSE/MISUSE)- SKIN CANCER SCREENINGS- MENTAL HEALTH AWARENESS CRISIS EDUCATION- EDUCATION FOR HEART HEALTH AND SCREENINGS AT LOCAL EVENTS OPEN TO THE PUBLIC.- EDUCATION FOR DIABETES AND BLOOD PRESSURE SCREENINGS AT LOCAL EVENTS OPEN TO THE PUBLIC.- GREW HOSPITAL USE OF TELEHEALTH FOR ID, NEUROLOGY, HEMATOLOGY/ONCOLOGY AND INTENSIVIST TO HELP WITH ACCESS TO CARE.- CARDIOVASCULAR RISK ASSESSMENT- MENTAL HEALTH SCREENINGS- PROJECT DAWN AWARENESS EDUCATION</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS ESTIMATED TO BE 43% OF THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPANY'S PATIENT ACCOUNTS RECEIVABLE IS REDUCED BY ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE COMPANY ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCES FOR BOTH CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THESE ALLOWANCES. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE COMPANY RECORDS A PROVISION FOR DOUBTFUL ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN EXPECTED RATES (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL CONTENDS THAT THE ENTIRE AMOUNT OF THE MEDICARE SURPLUS SHOULD ALSO BE CONSIDERED AS A COMMUNITY BENEFIT. THE REASON FOR THIS IS THAT THE MEDICARE RATES ARE SET UNILATERALLY BY THE FEDERAL GOVERNMENT AND THE HOSPITAL AGREES TO SERVICE THESE PATIENTS AT THESE RATES AS PART OF OUR MISSION AND SERVICE TO THE COMMUNITY.THE COST INCLUDED ON LINE 6 COMES FROM THE MEDICARE COST REPORT WHICH THE FEDERAL GOVERNMENT HAS SET UP AS THEIR WAY TO CAPTURE AND SEGREGATE THE COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL PRACTICE IS THAT UPON VERIFICATION THAT A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, THE HOSPITAL DISCONTINUES COLLECTION EFFORTS AND MAKES THE APPROPRIATE ADJUSTMENT TO THE PATIENT'S ACCOUNT BASED UPON THE PATIENT'S INDIVIDUAL CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>ONGOING EFFORTS AND EVALUATION OF MANAGEMENT, STAFF, PHYSICIANS WITH FEEDBACK FROM PATIENTS AND COMMUNITY. DEMOGRAPHIC RESEARCH AND STUDIES ALSO UTILIZED TO DETERMINE TYPE AND QUANTITY OF SERVICES NEEDED BY SPECIALTY TO BEST SERVE OUR COMMUNITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>INFORMATION REGARDING FINANCIAL ASSISTANCE AND CHARITY CARE IS MADE AVAILABLE AT TIME OF REGISTRATION, ON THE HOSPITAL'S WEBSITE, AND ON PATIENT STATEMENTS. APPLICATIONS ARE ALSO MADE AVAILABLE TO PATIENTS AT TIME OF REGISTRATION IF APPROPRIATE.IN ORDER TO ENSURE THAT PATIENTS ARE AWARE OF THE EXISTENCE OF THE FINANCIAL ASSISTANCE POLICY, THE HOSPITAL WIDELY DISSEMINATES THE EXISTENCE AND TERMS OF THIS POLICY THROUGHOUT ITS SERVICE AREA. IN ADDITION TO OTHER APPROPRIATE EFFORTS TO INFORM THE COMMUNITY ABOUT THE POLICY IN A WAY TARGETED TO REACH COMMUNITY MEMBERS MOST LIKELY TO NEED FINANCIAL ASSISTANCE, THE FOLLOWING ACTIONS ARE TAKEN:A. WRITTEN NOTICE TO ALL PATIENTSEACH PATIENT WHO IS SEEN, WHETHER ADMITTED OR NOT, SHALL RECEIVE THE PLAIN LANGUAGE SUMMARY. THE NOTICE SHALL BE PROVIDED IN NON-ENGLISH LANGUAGES SPOKEN BY A SUBSTANTIAL NUMBER OF THE PATIENTS SERVED BY THE HOSPITAL.B. POSTING OF NOTICESTHE FINANCIAL ASSISTANCE POLICY SHALL BE CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS THAT ARE VISIBLE TO THE PATIENTS IN THE FOLLOWING AREAS: (1) EMERGENCY DEPARTMENT; (2) BILLING OFFICE; (3) ADMISSIONS OFFICE; AND (4) OTHER OUTPATIENT SETTINGS. THE NOTICE SHALL BE PROVIDED IN NON-ENGLISH LANGUAGES SPOKEN BY A SUBSTANTIAL NUMBER OF THE PATIENTS SERVED BY THE HOSPITAL.C. NOTICE TO ACCOMPANY BILLING STATEMENTSEVERY POST DISCHARGE STATEMENT SHALL INCLUDE A COPY OF THE NOTICE. EACH BILL THAT IS SENT TO A PATIENT WHO HAS NOT PROVIDED PROOF OF COVERAGE BY A THIRD PARTY AT THE TIME CARE IS PROVIDED OR UPON DISCHARGE MUST INCLUDE A STATEMENT OF CHARGES FOR SERVICES RENDERED BY THE HOSPITAL. THESE NOTICES SHALL BE PROVIDED IN NON-ENGLISH LANGUAGES SPOKEN BY A SUBSTANTIAL NUMBER OF THE PATIENTS SERVED BY THE HOSPITAL.D. AVAILABILITY OF FINANCIAL ASSISTANCE DOCUMENTSTHE HOSPITAL SHALL POST A COPY OF THIS POLICY, THE PLAIN LANGUAGE SUMMARY AND THE FINANCIAL ASSISTANCE APPLICATION ON ITS WEBSITE AND MAKE ALL SUCH DOCUMENTS AVAILABLE FOR FREE DOWNLOAD. SUCH DOCUMENTS SHALL BE AVAILABLE IN THE EMERGENCY ROOM AND ADMISSIONS OFFICE AND BY MAIL UPON REQUEST. THE DOCUMENTS SHALL BE PROVIDED IN NON-ENGLISH LANGUAGES SPOKEN BY A SUBSTANTIAL NUMBER OF THE PATIENTS SERVED BY THE HOSPITAL.E. ACCESSIBILITY TO LIMITED ENGLISH PROFICIENT INDIVIDUALSTHE HOSPITAL SHALL MAKE TRANSLATIONS OF THIS POLICY, THE PLAIN LANGUAGE SUMMARY, AND THE FINANCIAL ASSISTANCE APPLICATION AVAILABLE IN ANY LANGUAGE THAT IS THE PRIMARY LANGUAGE OF THE LESSER OF ONE THOUSAND (1,000) INDIVIDUALS OR FIVE PERCENT (5%) OF THE POPULATION OF THE COMMUNITIES SERVED BY THE HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>COLUMBIANA COUNTY IS LOCATED IN NORTHEASTERN OHIO AND IS ONE OF OHIO'S 32 APPALACHIAN COUNTIES. IT IS BORDERED ON THE NORTH BY MAHONING COUNTY, ON THE EAST BY PENNSYLVANIA, ON THE SOUTH BY THE OHIO RIVER AND WEST VIRGINIA, AND ON THE WEST BY JEFFERSON, CARROLL AND STARK COUNTIES. OVER HALF OF THE COUNTY'S TOTAL POPULATION OF 99,823 LIVES IN UNINCORPORATED RURAL AREAS, WITH VILLAGES AND TOWNS SOME DISTANCE APART. THE COUNTY HAS TWO MAJOR GEOGRAPHIC CONCENTRATIONS OF DEVELOPMENT AND POPULATION. THE NORTHERN CORRIDOR BETWEEN THE CITIES OF SALEM AND EAST PALESTINE (INCLUDING THE VILLAGES OF WASHINGTONVILLE, LEETONIA, COLUMBIANA, AND NEW WATERFORD AND THE FOUR TOWNSHIPS OF PERRY, SALEM, FAIRFIELD, AND UNITY) EXTENDS ALONG A 20-MILE DISTANCE BORDERING MAHONING COUNTY TO THE NORTH, AND CONTAINS ALMOST 44% OF THE COUNTY'S POPULATION. THE SOUTHERN CORRIDOR EXTENDS FOR ABOUT 10 MILES FROM THE VILLAGE OF WELLSVILLE TO EAST LIVERPOOL, (INCLUDING ST. CLAIR TOWNSHIP) AND CONTAINS 13% OF THE COUNTY'S TOTAL POPULATION. CITY HOSPITAL ASSOCIATION OPERATES THE ONLY HOSPITAL, EAST LIVERPOOL CITY HOSPITAL, WITHIN 20 MILES OF THE CITY. THE HOSPITAL SERVES PATIENTS WITHIN A 10 TO 15-MILE RADIUS INCLUDING PATIENTS FROM NEIGHBORING PENNSYLVANIA AND WEST VIRGINIA. MOST RESIDENTS HAVE LIVED HERE ALL THEIR LIVES AND THE COMMUNITY IS COMPRISED OF A SIGNIFICANT BIAS OF SENIOR CITIZENS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>CITY HOSPITAL ASSOCIATION HAS AN OPEN MEDICAL STAFF, A COMMUNITY BOARD OF TRUSTEES AND IS EXTREMELY GENEROUS WITH FUNDING COMMUNITY CHARITIES AND DONATING EMPLOYEE TIME TO SERVE THE GENERAL POPULATION OF THE AREA SERVED. THIS INCLUDES PARTICIPATING IN COMMUNITY HEALTH FAIRS, SCHOOL PROGRAMS, AND FREE PUBLIC SPEAKING REGARDING TOPICS RECOGNIZED AS IMPLEMENTATION PRIORITIES IN THE 2022 CHNA. ELCH OFFERS FREE SMOKING CESSATION, DIABETES EDUCATION, AND HEALTH NUTRITION TO ALL COMMUNITY MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>AFFILIATED HEALTH CARE SYSTEMCITY HOSPITAL ASSOCIATION IS A SUBSIDIARY OF PRIME HEALTHCARE FOUNDATION, INC. (PHF). PHF AND ITS SUBSIDIARIES ARE THEIR OWN HEALTH SYSTEM MANAGED BY PRIME HEALTHCARE MANAGEMENT, INC.PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORTTHIS IS NOT APPLICABLE TO CITY HOSPITAL ASSOCIATION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
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      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
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      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
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        <PersonNm>GRETCHEN NICKELL DO</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>319664</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>351000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>1214</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsRltdOrgsAmt>33807</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>725035</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <PersonNm>DEREK HARSHAW</PersonNm>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>23000</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>22590</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>437262</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEPHANIE CONN</PersonNm>
        <TitleTxt>CEO (START 6/24)</TitleTxt>
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        <OtherCompensationFilingOrgAmt>6057</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>6063</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11582</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>11418</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14229</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>15275</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>202548</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>168163</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM SMITH</PersonNm>
        <TitleTxt>DIRECTOR OF PHARMACY</TitleTxt>
        <BaseCompensationFilingOrgAmt>140711</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>2000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>12594</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>15929</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>34105</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>205339</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TERESA PASCO</PersonNm>
        <TitleTxt>REGIONAL DIRECTOR OF HUMAN RESOURCES</TitleTxt>
        <BaseCompensationFilingOrgAmt>130885</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>10500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>682</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7093</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>36629</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>185789</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMIE MCKENZIE</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>123608</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1531</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7643</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>34354</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>177136</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAWN GERZ</PersonNm>
        <TitleTxt>CNO</TitleTxt>
        <BaseCompensationFilingOrgAmt>124271</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>26931</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>22448</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1589</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>175239</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JESSE SHILOT</PersonNm>
        <TitleTxt>PHARMACIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>131254</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>917</OtherCompensationFilingOrgAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>161316</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NICHOLAS PETRUSKA</PersonNm>
        <TitleTxt>PHARMACIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>133553</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2885</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>CITY HOSPITAL ASSOCIATION ALLOWS COMPANION TRAVEL BY EXECUTIVES ONLY WHEN IT SERVES A JUSTIFIED BUSINESS PURPOSE. IF IT IS LATER DETERMINED THAT THERE WAS NOT A JUSTIFIED BUSINESS PURPOSE, THIS WILL RESULT IN TAXABLE COMPENSATION TO THE EXECUTIVE IN QUESTION. CITY HOSPITAL ASSOCIATION PROVIDES A MEMBERSHIP TO AN AREA SOCIAL CLUB IN ORDER FOR EXECUTIVES TO CONDUCT HOSPITAL BUSINESS. ANY PERSONAL USE BY THE EXECUTIVES IS INCLUDED IN THAT EXECUTIVE'S TAXABLE WAGES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>A RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY OFFICER COMPENSATION IS ESTABLISHED BY PRIME HEALTHCARE MANAGEMENT, INC. IN ACCORDANCE WITH A MANAGEMENT AGREEMENT. WRITTEN EMPLOYMENT CONTRACTS ARE FORWARDED TO THE FACILITY ONCE EXECUTED. COMPENSATION SURVEY OR STUDIES ARE UTILIZED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>BONUS PAYMENTS ARE DISCRETIONARY IN NATURE</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>PRIME HEALTHCARE MANAGEMENT II INC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>4997393</TransactionAmt>
        <TransactionDesc>MANAGEMENT FEE</TransactionDesc>
        <SharingOfRevenuesInd>1</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>BIO-MED SERVICES INC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>1074962</TransactionAmt>
        <TransactionDesc>MEDICAL EQUIPMENT MANAGEMENT</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE (1), COLUMN (B):</FormAndLineReferenceDesc>
        <ExplanationTxt>ENTITY IS INDIRECTLY OWNED BY DR. PREM REDDY, FOUNDER OF PRIME HEALTHCARE FOUNDATION AND A FORMER DIRECTOR AND OFFICER OF PRIME HEALTHCARE FOUNDATION WHO RESIGNED FROM SUCH POSITIONS ON JANUARY 29, 2016, AND LATER RESIGNED FROM A NON-VOTING POSITION (CHAIR-EMERITUS) ON OCTOBER 27, 2016. ENTITY IS ALSO INDIRECTLY OWNED BY DR. KAVITHA BHATIA, WHO HAS A FAMILY RELATIONSHIP WITH DR. PREM REDDY, SERVES AS PRESIDENT OF THE ORGANIZATION, AND SERVES AS PRESIDENT AND CHAIR OF THE BOARD OF PRIME HEALTHCARE FOUNDATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE (2), COLUMN (B):</FormAndLineReferenceDesc>
        <ExplanationTxt>ENTITY IS OWNED BY DR. PREM REDDY, FOUNDER OF PRIME HEALTHCARE FOUNDATION AND A FORMER DIRECTOR AND OFFICER OF PRIME HEALTHCARE FOUNDATION WHO RESIGNED FROM SUCH POSITIONS ON JANUARY 29, 2016, AND LATER RESIGNED FROM A NON-VOTING POSITION (CHAIR-EMERITUS) ON OCTOBER 27, 2016. ENTITY IS ALSO DIRECTLY OWNED BY DR. KAVITHA BHATIA, WHO HAS A FAMILY RELATIONSHIP WITH DR. PREM REDDY, SERVES AS PRESIDENT OF THE ORGANIZATION, AND SERVES AS PRESIDENT AND CHAIR OF THE BOARD OF PRIME HEALTHCARE FOUNDATION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>KAVITHA BHATIA, JAMES A. GILMAN, AND STEVEN ALEMAN HAVE A BUSINESS RELATIONSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS BEING MANAGED BY PRIME HEALTHCARE MANAGEMENT, INC., AN AFFILIATE OF PRIME HEALTHCARE FOUNDATION, INC. (PHF). THE COMPANY PROVIDES MANAGEMENT AND ADMINISTRATIVE SERVICES TO THE FILING ORGANIZATION AND EACH OF THE HOSPITAL FACILITIES IN THE ORGANIZATION. SERVICES INCLUDE, MANAGEMENT, LEGAL, INFORMATION TECHNOLOGY AND REVENUE CYCLE MANAGEMENT. THE FOLLOWING OFFICERS LISTED ON PART VII ARE EMPLOYED BY THE MANAGEMENT COMPANY TO PROVIDE SERVICES TO A VARIETY OF HOSPITALS ON AN AS-NEEDED BASIS AND RECEIVED THE FOLLOWING AMOUNT OF COMPENSATION FROM THE MANAGEMENT COMPANY FOR SERVICES PROVIDED TO PRIME HEALTHCARE FOUNDATION AND ITS SUBSIDIARIES: KAVITHA BHATIA - $72,283 STEVE ALEMAN - $84,445 JAMES A. GILMAN - $72,118</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIME HEALTHCARE FOUNDATION, INC. (PHF) IS THE SOLE CORPORATE CONTROLLING MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIME HEALTHCARE FOUNDATION, INC. (PHF) HAS THE POWER TO APPOINT THE BOARD MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIME HEALTHCARE FOUNDATION, INC. (PHF), THE SOLE CORPORATE MEMBER, HOLDS CERTAIN RESERVED POWERS AS SET FORTH IN THE ARTICLES OF INCORPORATION. PHF HAS THE POWER TO APPOINT THE BOARD MEMBERS AND APPROVE ANY AMENDMENTS OF THE ORGANIZATION'S ARTICLES OR BYLAWS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORMS ARE REVIEWED BY THE ORGANIZATION'S CFO AND OUTSIDE COUNSEL PRIOR TO FILING AND THEN THE RETURNS ARE PROVIDED TO THE BOARD FOR THEIR REVIEW CONTEMPORANEOUSLY WITH THEIR FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE REVIEW OF QUESTIONNAIRES THAT OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>A RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY OFFICER COMPENSATION IS ESTABLISHED BY PRIME HEALTHCARE MANAGEMENT, INC. IN ACCORDANCE WITH A MANAGEMENT AGREEMENT. WRITTEN EMPLOYMENT CONTRACTS ARE FORWARDED TO THE FACILITY ONCE EXECUTED. COMPENSATION SURVEY OR STUDIES ARE UTILIZED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER CLINICAL REG/TEMP HELP: PROGRAM SERVICE EXPENSES 135,458. MANAGEMENT AND GENERAL EXPENSES 90,306. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 225,764. PHYSICIAN ON-CALL MED FEES: PROGRAM SERVICE EXPENSES 456,878. MANAGEMENT AND GENERAL EXPENSES 304,586. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 761,464. MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 201,762. MANAGEMENT AND GENERAL EXPENSES 134,508. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 336,270. CONSULTING AND MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 87,451. MANAGEMENT AND GENERAL EXPENSES 58,301. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 145,752. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,440,433. MANAGEMENT AND GENERAL EXPENSES 2,293,626. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,734,059. MEDICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 463,911. MANAGEMENT AND GENERAL EXPENSES 309,275. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 773,186. COLLECTION FEES: PROGRAM SERVICE EXPENSES 146,140. MANAGEMENT AND GENERAL EXPENSES 97,426. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 243,566. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,401,073. MANAGEMENT AND GENERAL EXPENSES 934,051. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,335,124. OTHER PURCHASED SERVICES BIO-MED: PROGRAM SERVICE EXPENSES 644,977. MANAGEMENT AND GENERAL EXPENSES 429,985. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,074,962. OTHER PURCHASED SERVICES BUSINESS OFFICE: PROGRAM SERVICE EXPENSES 427,649. MANAGEMENT AND GENERAL EXPENSES 285,099. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 712,748. OTHER PURCHASED SERVICES INFO TECH: PROGRAM SERVICE EXPENSES 115,117. MANAGEMENT AND GENERAL EXPENSES 76,745. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 191,862. OTHER PURCHASED SERVICES TELECOMM: PROGRAM SERVICE EXPENSES 8,881. MANAGEMENT AND GENERAL EXPENSES 5,921. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,802. SOFTWARE SUBSCRIPTIONS INFO TECH: PROGRAM SERVICE EXPENSES 69,580. MANAGEMENT AND GENERAL EXPENSES 46,386. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 115,966.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <ZIPCd>78596</ZIPCd>
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        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>KNAPP MEDICAL GROUP</BusinessNameLine1Txt>
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          <AddressLine1Txt>1401 E 8TH STREET</AddressLine1Txt>
          <CityNm>WESLACO</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78596</ZIPCd>
        </USAddress>
        <EIN>271619835</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>KMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CALIFORNIA UNIVERSITY OF SCIENCE AND MEDICINE</BusinessNameLine1Txt>
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          <AddressLine1Txt>3300 E GUASTI ROAD SUITE 300</AddressLine1Txt>
          <CityNm>ONTARIO</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>91761</ZIPCd>
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        <EIN>464141445</EIN>
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        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>LINE 2</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHF</BusinessNameLine1Txt>
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          <CityNm>MISSION</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78572</ZIPCd>
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        <EIN>742206635</EIN>
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        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
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      <IdRelatedTaxExemptOrgGrp>
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      <IdRelatedTaxExemptOrgGrp>
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          <AddressLine1Txt>ONE MEDICAL PLAZA</AddressLine1Txt>
          <CityNm>PAMPA</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>79065</ZIPCd>
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</Return>