﻿<?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>2026-02-16T14:19:59+00:00</ReturnTs>
    <TaxPeriodEndDt>2025-03-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>440160260</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Forvis Mazars LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>312 Walnut Street Suite 3000</AddressLine1Txt>
        <CityNm>Cincinnati</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>45202</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-04-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>610920842</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Bowling Green Warren County Community Hospital Corporation</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>BOWL</BusinessNameControlTxt>
      <PhoneNum>2707451551</PhoneNum>
      <USAddress>
        <AddressLine1Txt>800 Park Street</AddressLine1Txt>
        <CityNm>Bowling Green</CityNm>
        <StateAbbreviationCd>KY</StateAbbreviationCd>
        <ZIPCd>42101</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Michelle Lawless</PersonNm>
      <PersonTitleTxt>EVP - CFO</PersonTitleTxt>
      <SignatureDt>2026-02-16</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Aaron Hershberger</PreparerPersonNm>
      <PTIN>P00961884</PTIN>
      <PhoneNum>5136218300</PhoneNum>
      <PreparationDt>2026-01-30</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="12">
    <IRS990 documentId="IRS990" softwareId="24020961" softwareVersionNum="2024v5.1">
      <PrincipalOfcrBusinessName>
        <BusinessNameLine1Txt>CONNIE D SMITH</BusinessNameLine1Txt>
      </PrincipalOfcrBusinessName>
      <USAddress>
        <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
        <CityNm>BOWLING GREEN</CityNm>
        <StateAbbreviationCd>KY</StateAbbreviationCd>
        <ZIPCd>42101</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>1550053177</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>HTTPS://MEDCENTERHEALTH.ORG/</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1977</FormationYr>
      <LegalDomicileStateCd>KY</LegalDomicileStateCd>
      <ActivityOrMissionDesc>PROVIDES INPATIENT AND OUTPATIENT ACUTE CARE SERVICES BY OR UNDER THE SUPERVISION OF PHYSICIANS IN BOWLING GREEN, KENTUCKY AND IN THE SURROUNDING COUNTIES.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>13</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>10</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>3307</TotalEmployeeCnt>
      <TotalVolunteersCnt>55</TotalVolunteersCnt>
      <TotalGrossUBIAmt>6103832</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>86734</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>317907</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>694296</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>608724904</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>743052494</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>12501806</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>72640093</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>16139936</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>22392630</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>637684553</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>838779513</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>14900</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>43063</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>199055752</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>244871860</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>339038659</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>423833592</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>538109311</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>668748515</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>99575242</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>170030998</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>1101394731</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>1285463047</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>323954802</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>326376153</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>777439929</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>959086894</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>OUR MISSION IS TO CARE FOR PEOPLE AND IMPROVE THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>362592735</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>442345529</RevenueAmt>
      <Desc>Med Center Health provides a wide range of outpatient services designed to improve access to high-quality healthcare for patients across South-central Kentucky. Outpatient care includes diagnostic, preventive, therapeutic, and rehabilitative services that allow patients to receive needed medical treatment without requiring hospital admission. Services are delivered through hospital outpatient departments, ambulatory clinics, and specialty practices, and are available to patients regardless of their ability to pay. SEE SCHEDULE O FOR MORE DETAIL OF SERVICES THE HOSPITAL PROVIDES.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>241638373</ExpenseAmt>
        <GrantAmt>43063</GrantAmt>
        <RevenueAmt>319839367</RevenueAmt>
        <Desc>INPATIENT SERVICES: Med Center Health provides comprehensive inpatient services to meet the acute and complex healthcare needs of patients in South-central Kentucky. Inpatient care includes admission to the hospital for diagnostic evaluation, medical and surgical treatment, and continuous nursing care. Services are available to all patients, regardless of their ability to pay, and are delivered in a safe, patient-centered environment focused on quality outcomes and compassionate care. SEE SCHEDULE O FOR MORE DETAIL OF SERVICES THE HOSPITAL PROVIDES.</Desc>
      </ProgSrvcAccomActy2Grp>
      <TotalProgramServiceExpensesAmt>604231108</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>false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd>false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">true</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 referenceDocumentId="IRS990ScheduleI">true</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="IRS990ScheduleI">true</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="IRS990ScheduleK1">true</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>false</InvestTaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="IRS990ScheduleL">true</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd referenceDocumentId="IRS990ScheduleL">true</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="IRS990ScheduleR">true</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="IRS990ScheduleR">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>true</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="IRS990ScheduleR">true</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <InfoInScheduleOPartVInd>X</InfoInScheduleOPartVInd>
      <IRPDocumentCnt>364</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>3307</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>true</Form990TFiledInd>
      <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>13</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>10</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>false</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>true</InvestmentInJointVentureInd>
      <WrittenPolicyOrProcedureInd>true</WrittenPolicyOrProcedureInd>
      <StatesWhereCopyOfReturnIsFldCd>KY</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>JENNY GREENWELL</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>2707451551</PhoneNum>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR ELI JACKSON III</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2740</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR PAUL COOK</PersonNm>
        <TitleTxt>VICE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR JOE NATCHER</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>4.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2740</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS CONNIE D SMITH</PersonNm>
        <TitleTxt>PRESIDENT / CEO</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>52.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1353837</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>132368</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR DONNA BLACKBURN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2740</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR DOUG THOMSON</PersonNm>
        <TitleTxt>DIRECTOR / PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>2522</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR JACKIE POPE-TARRENCE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>6696</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR MOHAMMED KAZIMUDDIN</PersonNm>
        <TitleTxt>DIRECTOR / PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>334767</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3584</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR WILLIAM MOSS</PersonNm>
        <TitleTxt>DIRECTOR / PHYSICIAN / CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>388786</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32703</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR STEVE THURMOND</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2740</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR TOMMY LOVING</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2740</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS CATHY BISHOP</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>4.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2740</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS JANET JOHNSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2740</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR DAVID GRAY</PersonNm>
        <TitleTxt>EXECUTIVE VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>50.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>453850</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>49504</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR WADE STONE</PersonNm>
        <TitleTxt>EXECUTIVE VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>50.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>465735</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>80371</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS KATRINA WOOD</PersonNm>
        <TitleTxt>EVP / CHIEF NURSING OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>50.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>317031</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>89125</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS MICHELE W LAWLESS</PersonNm>
        <TitleTxt>EXECUTIVE VICE PRESIDENT / CFO</TitleTxt>
        <AverageHoursPerWeekRt>2.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>50.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>540323</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>111149</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR ERIC HAGAN</PersonNm>
        <TitleTxt>VP OF RURAL HOSPITALS</TitleTxt>
        <AverageHoursPerWeekRt>28.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>12.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>310314</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>85667</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR CATRINIA DRUEN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>498846</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21102</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR DANIEL L DAVIS</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>593881</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43986</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR DARIN L PASSER</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>638371</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>47657</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR JOSEPH GRAU</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>376813</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>75031</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR SHAFIA RUBEEN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>378373</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36494</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3846400</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>2832925</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>808741</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>258</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>QUALIVIS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 674913</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>752674913</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>STAFFING SERVICES</ServicesDesc>
        <CompensationAmt>11023786</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TMX HEALTHCARE TECHNOLOGIES LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 636129</AddressLine1Txt>
            <CityNm>CINCINNATI</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45263</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>BIOMED EQUIP REPAIR</ServicesDesc>
        <CompensationAmt>8685806</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>KELLEY CONSTRUCTION INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>12550 LAKE STATION PLACE</AddressLine1Txt>
            <CityNm>LOUISVILLE</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>40299</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION SERVICES</ServicesDesc>
        <CompensationAmt>7300985</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>UNIVERSITY OF KENTUCKY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2355 HUGUENARD DRIVE</AddressLine1Txt>
            <AddressLine2Txt>SUITE 201A</AddressLine2Txt>
            <CityNm>LEXINGTON</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>40503</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>GRAD MEDICAL EDU</ServicesDesc>
        <CompensationAmt>6864976</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WEHR CONSTRUCTORS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2517 PLANTSIDE DRIVE</AddressLine1Txt>
            <CityNm>LOUISVILLE</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>40299</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION SERVICES</ServicesDesc>
        <CompensationAmt>5694347</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>72</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>258713</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>435583</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>0</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>694296</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>INPATIENT SERVICES</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>319722485</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>319722485</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OUTPATIENT SERVICES</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>408721349</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>408721349</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RETAIL PHARMACY SALES</Desc>
        <BusinessCd>446110</BusinessCd>
        <TotalRevenueColumnAmt>12042414</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7343347</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>4699067</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAL EQUIPMENT SALES</Desc>
        <BusinessCd>453000</BusinessCd>
        <TotalRevenueColumnAmt>2331394</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>926629</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>1404765</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PHYSICIAN PRACTICES</Desc>
        <BusinessCd>566927</BusinessCd>
        <TotalRevenueColumnAmt>234852</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>234852</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>743052494</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>17866627</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>17866627</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>4887365</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>7730969</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>-2843604</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-2843604</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-2843604</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>758307161</SecuritiesAmt>
        <OtherAmt>9000</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>703542695</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>54764466</SecuritiesAmt>
        <OtherAmt>9000</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>54773466</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>54773466</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>GRADUATE MEDICAL EDUCATION RESIDENTS</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>14816833</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>14816833</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>5814473</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5814473</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAPITATION AND QUALITY PROGRAM</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>2545058</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2545058</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>2059870</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2059870</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>25236234</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>838779513</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>762184896</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>6103832</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>69796489</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>31011</TotalAmt>
        <ProgramServicesAmt>31011</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>12052</TotalAmt>
        <ProgramServicesAmt>12052</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1460617</TotalAmt>
        <ProgramServicesAmt>1390033</ProgramServicesAmt>
        <ManagementAndGeneralAmt>70584</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>190742904</TotalAmt>
        <ProgramServicesAmt>181525230</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9217674</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>8675108</TotalAmt>
        <ProgramServicesAmt>8255882</ProgramServicesAmt>
        <ManagementAndGeneralAmt>419226</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>29949264</TotalAmt>
        <ProgramServicesAmt>28501962</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1447302</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>14043967</TotalAmt>
        <ProgramServicesAmt>13359507</ProgramServicesAmt>
        <ManagementAndGeneralAmt>684460</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>22378556</TotalAmt>
        <ProgramServicesAmt>1746956</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20631600</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>763726</TotalAmt>
        <ProgramServicesAmt>40478</ProgramServicesAmt>
        <ManagementAndGeneralAmt>723248</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>929892</TotalAmt>
        <ProgramServicesAmt>746147</ProgramServicesAmt>
        <ManagementAndGeneralAmt>183745</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>23555</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23555</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>815216</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>815216</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>80265520</TotalAmt>
        <ProgramServicesAmt>74483359</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5782161</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>1170725</TotalAmt>
        <ProgramServicesAmt>312749</ProgramServicesAmt>
        <ManagementAndGeneralAmt>857976</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>34527046</TotalAmt>
        <ProgramServicesAmt>23578900</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10948146</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>11419017</TotalAmt>
        <ProgramServicesAmt>4183608</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7235409</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>5653708</TotalAmt>
        <ProgramServicesAmt>5585862</ProgramServicesAmt>
        <ManagementAndGeneralAmt>67846</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>1366053</TotalAmt>
        <ProgramServicesAmt>1324127</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41926</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>1109300</TotalAmt>
        <ProgramServicesAmt>1042257</ProgramServicesAmt>
        <ManagementAndGeneralAmt>67043</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>19030806</TotalAmt>
        <ProgramServicesAmt>15524347</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3506459</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>11557965</TotalAmt>
        <ProgramServicesAmt>10883190</ProgramServicesAmt>
        <ManagementAndGeneralAmt>674775</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>150663433</TotalAmt>
        <ProgramServicesAmt>150663433</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PHYSICIAN PRACTICE EXPENSE</Desc>
        <TotalAmt>53568866</TotalAmt>
        <ProgramServicesAmt>53568866</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TAXES &amp; LICENSES</Desc>
        <TotalAmt>24604212</TotalAmt>
        <ProgramServicesAmt>24599940</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4272</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Miscellaneous</Desc>
        <TotalAmt>3985996</TotalAmt>
        <ProgramServicesAmt>2871212</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1114784</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>668748515</TotalAmt>
        <ProgramServicesAmt>604231108</ProgramServicesAmt>
        <ManagementAndGeneralAmt>64517407</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>72740801</BOYAmt>
        <EOYAmt>64261128</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>525378618</BOYAmt>
        <EOYAmt>607432772</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>65095783</BOYAmt>
        <EOYAmt>101662178</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>18791256</BOYAmt>
        <EOYAmt>21931149</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>7734258</BOYAmt>
        <EOYAmt>9415011</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>641436063</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>375016758</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>157417439</BOYAmt>
        <EOYAmt>266419305</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>209333131</BOYAmt>
        <EOYAmt>147114450</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>1848355</BOYAmt>
        <EOYAmt>1881844</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>4930974</BOYAmt>
        <EOYAmt>4930974</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>38124116</BOYAmt>
        <EOYAmt>60414236</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>1101394731</BOYAmt>
        <EOYAmt>1285463047</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>53140877</BOYAmt>
        <EOYAmt>69937627</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>245053539</BOYAmt>
        <EOYAmt>230492062</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>951772</BOYAmt>
        <EOYAmt>6922832</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>24808614</BOYAmt>
        <EOYAmt>19023632</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>323954802</BOYAmt>
        <EOYAmt>326376153</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>775124306</BOYAmt>
        <EOYAmt>957270644</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>2315623</BOYAmt>
        <EOYAmt>1816250</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <CapStkTrPrinCurrentFundsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </CapStkTrPrinCurrentFundsGrp>
      <PdInCapSrplsLandBldgEqpFundGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PdInCapSrplsLandBldgEqpFundGrp>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>777439929</BOYAmt>
        <EOYAmt>959086894</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>1101394731</BOYAmt>
        <EOYAmt>1285463047</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>170030998</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-41055313</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>45738505</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>6932775</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="24020961" softwareVersionNum="2024v5.1">
      <HospitalInd>X</HospitalInd>
    </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>23555</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>23555</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY</FormAndLineReferenceDesc>
        <ExplanationTxt>13.7% OF THE DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION REPRESENT LOBBYING EXPENSES. THE LOBBYING PORTION OF DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION DURING THE FISCAL YEAR TOTALED $23,555</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="24020961" softwareVersionNum="2024v5.1">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>569817172</BeginningYearBalanceAmt>
        <ContributionsAmt>69122701</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>32294773</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>62611696</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>831138</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>607791812</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>463075397</BeginningYearBalanceAmt>
        <ContributionsAmt>63340740</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>48915803</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>4625488</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>889280</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>569817172</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>473151532</BeginningYearBalanceAmt>
        <ContributionsAmt>78360597</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-16763014</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>70934053</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>739665</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>463075397</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>454319398</BeginningYearBalanceAmt>
        <ContributionsAmt>32775272</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>1694808</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>14768674</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>869272</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>473151532</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>307990745</BeginningYearBalanceAmt>
        <ContributionsAmt>90848943</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>56274123</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>0</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>794413</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>454319398</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.99</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.01</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.0</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>27866523</OtherCostOrOtherBasisAmt>
        <BookValueAmt>27866523</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>311593656</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>172131455</DepreciationAmt>
        <BookValueAmt>139462201</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>257305497</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>195827429</DepreciationAmt>
        <BookValueAmt>61478068</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>44670387</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>7057874</DepreciationAmt>
        <BookValueAmt>37612513</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>266419305</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Federal Income Taxes</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO MEDICARE/MEDICAID</Desc>
        <Amt>6207519</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATES</Desc>
        <Amt>372647</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITIES</Desc>
        <Amt>732702</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LONG-TERM WORK COMP LIABILITY</Desc>
        <Amt>11201733</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>UNEARNED INCOME</Desc>
        <Amt>509031</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>19023632</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>809561484</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-41055313</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>1355170</OtherRevenueAmt>
      <RevenueNotReportedAmt>-39700143</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>849261627</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>815216</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>-11297330</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-10482114</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>838779513</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>675664246</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>7730969</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>7730969</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>667933277</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>815216</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>22</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>815238</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>668748515</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part X, Line 2 INCOME TAXES</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DID NOT INCLUDE A FOOTNOTE THAT ADDRESSED THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN48 (ASC 740). MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part V, Line 4 Intended uses of endowment funds</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER'S ENDOWMENT CONSISTS OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS (BOARD-DESIGNATED ENDOWMENT FUNDS). AS REQUIRED BY GAAP, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING BOARD-DESIGNATED ENDOWMENT FUNDS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. UNRESTRICTED NET ASSETS INCLUDED $605,975,563 OF BOARD-DESIGNATED ENDOWMENT FUNDS FOR FUTURE CAPITAL IMPROVEMENTS AND OTHER PURPOSES AS DETERMINED BY THE BOARD OF DIRECTORS. FUNDS ON DEPOSIT WITH TRUSTEES IN CONNECTION WITH VARIOUS BOND INDENTURES, CALLED TRUSTEE-HELD FUNDS, ARE TO BE USED ONLY FOR INTEREST, RETIRING INDEBTEDNESS, OR CAPITAL EXPENDITURES AS SPECIFIED BY THE VARIOUS BOND INDENTURE AGREEMENTS. THE FUND BALANCE FOR TRUSTEE-HELD FUNDS IS $146,755,410. PERMANENTLY RESTRICTED NET ASSETS INCLUDED $1,816,250 OF DONOR-RESTRICTED ENDOWMENT FUNDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER COMPONENTS OF NET PERIODIC PENSION COSTS - 1355170</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements</FormAndLineReferenceDesc>
        <ExplanationTxt>Rent Expense netted against revenue per audit - -7730969 Excess of fair value of net assets acquired Logan Memorial - -3566403 ROUNDING - 42</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990</FormAndLineReferenceDesc>
        <ExplanationTxt>Rent Expense netted against revenue per audit - 7730969</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements</FormAndLineReferenceDesc>
        <ExplanationTxt>ROUNDING - 22</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH" softwareId="24020961" softwareVersionNum="2024v5.1">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent400Ind>X</Percent400Ind>
      <FinancialAssistanceAtCostTyp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>2226</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>7541225</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>7541225</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01128</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>5029448</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>108871</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4920577</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00736</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </UnreimbursedCostsGrp>
      <TotalFinancialAssistanceTyp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>2226</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>12570673</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>108871</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>12461802</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01863</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <ActivitiesOrProgramsCnt>242</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>15581</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>3944895</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>3944895</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00590</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <ActivitiesOrProgramsCnt>28</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>5444</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>3630566</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>3630566</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00543</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>11766724</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>9784249</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>1982475</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00296</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <ResearchGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </ResearchGrp>
      <CashAndInKindContributionsGrp>
        <ActivitiesOrProgramsCnt>918</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>222472</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>222472</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00033</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <ActivitiesOrProgramsCnt>1189</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>21025</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>19564657</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>9784249</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>9780408</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01462</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <ActivitiesOrProgramsCnt>1190</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>23251</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>32135330</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>9893120</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>22242210</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03326</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <PhysicalImprvAndHousingGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </PhysicalImprvAndHousingGrp>
      <EconomicDevelopmentGrp>
        <ActivitiesOrProgramsCnt>15</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>28780</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>28780</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00004</TotalExpensePct>
      </EconomicDevelopmentGrp>
      <CommunitySupportGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </CommunitySupportGrp>
      <EnvironmentalImprovementsGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </EnvironmentalImprovementsGrp>
      <LeadershipDevelopmentGrp>
        <ActivitiesOrProgramsCnt>2</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>2</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>2200</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>2200</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00000</TotalExpensePct>
      </LeadershipDevelopmentGrp>
      <CoalitionBuildingGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </CoalitionBuildingGrp>
      <HealthImprovementAdvocacyGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </HealthImprovementAdvocacyGrp>
      <WorkforceDevelopmentGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0</TotalExpensePct>
      </WorkforceDevelopmentGrp>
      <OtherCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>33300</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>33300</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00005</TotalExpensePct>
      </OtherCommuntityBuildingActyGrp>
      <TotalCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>18</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>2</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>64280</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>64280</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>38317930</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>8551555</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>215081289</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>287042021</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-71960732</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostAccountingSystemInd>X</CostAccountingSystemInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>6</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER AT BOWLING GREEN</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>250 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>HTTPS://WWW.MEDCENTERHEALTH.ORG/LOCATIONS</WebsiteAddressTxt>
        <StateLicenseNum>100404</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>2</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER AT SCOTTSVILLE</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>456 BURNLEY ROAD</AddressLine1Txt>
          <CityNm>SCOTTSVILLE</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42164</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>HTTPS://WWW.MEDCENTERHEALTH.ORG/LOCATIONS</WebsiteAddressTxt>
        <StateLicenseNum>600076</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>RURAL HEALTH CLINIC</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>3</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER AT CAVERNA</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1501 S DIXIE STREET</AddressLine1Txt>
          <CityNm>HORSE CAVE</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42749</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>HTTPS://WWW.MEDCENTERHEALTH.ORG/LOCATIONS</WebsiteAddressTxt>
        <StateLicenseNum>600065</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>RURAL HEALTH CLINIC</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>4</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER AT FRANKLIN</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1100 BROOKHAVEN RD</AddressLine1Txt>
          <CityNm>FRANKLIN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42134</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>HTTPS://WWW.MEDCENTERHEALTH.ORG/LOCATIONS</WebsiteAddressTxt>
        <StateLicenseNum>600069</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>RURAL HEALTH CLINIC</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>5</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER AT ALBANY</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>723 BURKESVILLE RD</AddressLine1Txt>
          <CityNm>ALBANY</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42602</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>HTTPS://WWW.MEDCENTERHEALTH.ORG/LOCATIONS</WebsiteAddressTxt>
        <StateLicenseNum>100078</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>6</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER AT RUSSELVILLE</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1625 NASHVILLE ST</AddressLine1Txt>
          <CityNm>RUSSELLVILLE</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42276</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>HTTPS://WWW.MEDCENTERHEALTH.ORG/LOCATIONS</WebsiteAddressTxt>
        <StateLicenseNum>100298</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>RURAL HEALTH CLINIC</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>A</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>6</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>25</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>true</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>true</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>25</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>200.0</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>400.0</FPGFamilyIncmLmtDscntCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <OtherCriteriaInd>X</OtherCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/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 A, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility A, 1 - FACILITY REPORTING GROUP A. For The Medical Center at Bowling Green (MCBG), The Medical Center at Caverna (MCC), The Medical Center at Franklin (MCF), The Medical Center at Russellville (MCR), and The Medical Center at Scottsville (MCS), the goal was to increase the number of surveys completed while more importantly ensuring that survey responses represented the diversity of the community. In Warren County specifically this meant intentionally reaching out to the refugee and immigrant populations as well as the entities serving those populations. Input was considered from 1,783 survey participants. To gather more information, members of the data committee conducted individual interviews with leaders from The Foundry Bowling Green and the International Center of Kentucky in addition to two Family Resource Youth Services Center directors from local schools. The members of Medical Center at Albany (MCA) CHNA steering committee participated in a focus group which included representation from the Clinton County health department, Clinton County Schools, Clinton County EMS and Emergency Services, Air Evac Lifeteam and Lake Cumberland District Health Department. Two additional focus groups were conducted with the Clinton County Chamber of Commerce and with the Clinton County Health Coalition. Input was considered from 157 respondents.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 6a Facility A, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility A, 1 - FACILITY REPORTING GROUP A. The CHNA was conducted in collaboration with other Med Center Health hospitals.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 6b Facility A, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility A, 1 - FACILITY REPORTING GROUP A. The CHNA for MCBG, MCC, MCF, MCR, and MCS was conducted with the BRIGHT Coalition, Barren River District Health Department, Western Kentucky University, and multiple nonprofit organizations. MCA contracted with the Community and Economic Development Initiative of Kentucky (CEDIK).</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility A, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility A, 1 - FACILITY REPORTING GROUP A. The Medical Center at Bowling Green identified obesity with an emphasis on nutrition and physical activity and tobacco cessation as the priorities in the next cycle year. Strategies include: nutrition education for community partners, Medical Nutrition Therapy, Diabetes Self-Management Education, promotion of physical activity through diabetes support groups, affordable healthy meal prep classes, one-on-one smoking cessation counseling, and school-based education on vaping. The focus will be on these areas with the goal of improving the overall health of the community while preventing or decreasing severity of chronic disease. The Medical Center at Albany prioritized increased health care, substance abuse, and the marketing of hospital and other community services. Strategies include: increase providers through travel clinics, rural health clinics, and telehealth, identify and refer patients to providers for substance abuse in a timely manner, partner with providers of substance use disorders services, track and educate providers on the proper use of opioids in treatment, provide information on health screenings and health care, maintain certification for acute stroke ready hospital, and obtain acute heart attack ready certification. The Medical Center at Caverna prioritized lung disease, substance abuse, and stroke readiness. Strategies include: promoting and increasing the availability of low-dose lung cancer screenings, maintaining status as a designated lung cancer screening center, collecting and analyzing cancer data, promoting awareness of treatment options for those chemically dependent, providing opioid abuse treatment options, collecting and analyzing data on patients in opioid addiction treatment, maintaining status as certified stroke ready, and reducing door to CT and lab results. The Medical Center at Franklin prioritized physical health, access to care, and social determinants of health. Strategies include: provide education on healthy eating, prevention and management of diabetes, signs and symptoms of heart attack and stroke, and counseling services for mental health. Strategies all include onboarding primary care providers at rural health clinics, obtaining acute heart attack ready certification and Trauma Level IV designation, and identify additional transportation options for patients. The Medical Center at Russellville prioritized access to mental health services and access to transportation. Strategies include reducing the stigma around mental health through education and educating the community of transportation options. MCR plans to partner with a transportation service. The Medical Center at Scottsville prioritized access to care, cardiovascular health, diabetes/prediabetes prevention and treatment, and mental health/substance use disorders in this cycle. Strategies include: providing information on available services and screenings, promoting telemedicine and primary care clinics, identifying resources for homeless and affordable medication, providing community education regarding the use of 911 and high blood pressure knowledge, maintaining stroke ready and acute heart attack certification, increase education on healthy eating, diabetes management early screening, and referrals. MCH plans to identify and refer patients to providers for mental health crisis stabilization or substance use disorders timely, offer detox programs, increase mental health education and number of providers. Needs Not Being Addressed: Mental health and substance use are ongoing issues identified by The Medical Center at Bowling Green in the BRADD region. While these will not be direct priorities focused on in this community health plan, they are ongoing issues that MCH continues to address. The Medical Center at Albany will continue to be involved in the activities of the Clinton County Healthy Hometown Coalition but will not address food insecurities as a priority. Transportation is directly tied to poverty-socioeconomic status of the community. The Medical Center at Albany will work with partnerships to address the transportation needs of individual patients through its case work process. The Medical Center at Franklin will not prioritize substance use or housing insecurity and livable wages at this time. However, it will support BRIGHT Coalition and other stakeholders. The Medical Center at Russellville acknowledges that tobacco use, obesity, and cost of care are needs that need to be addressed but feels that access to mental health care and transportation are the two biggest needs at this time. The Medical Center at Scottsville identifies vaccination and preventive health as having a positive impact on health. While these will not be direct priorities focused on in this community health plan, they are ongoing issues that MCH continues to address.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 13 Facility A, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility A, 1 - FACILITY REPORTING GROUP A. IT IS POSSIBLE THAT A PATIENT/GUARANTOR MAY OWE AN AMOUNT THAT IS LARGE IN RELATION TO THEIR INCOME AND STILL NOT MEET OUR STANDARD FINANCIAL ASSISTANCE (CHARITY CARE) GUIDELINES. WE DO NOT WISH TO CREATE A CIRCUMSTANCE COMMONLY KNOWN AS "MEDICAL INDIGENCY. THEREFORE, WE ALSO APPLY THE FOLLOWING GUIDELINES TO FINANCIAL ASSISTANCE APPLICATIONS: 1) ONLY PERSONS OR FAMILIES WHO MAKE LESS THAN 20 TIMES (2000%) OF THE SINGLE PERSON FEDERAL POVERTY LIMIT ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE. THE PURPOSE OF THIS REQUIREMENT IS TO LIMIT THE INCENTIVE TO NOT PURCHASE HEALTH INSURANCE IF A PERSON CAN AFFORD IT. 2) A SELF-PAY PORTION OF A BILL GREATER THAN 20% OF ANNUAL INCOME QUALIFIES A PERSON FOR CATASTROPHIC FINANCIAL ASSISTANCE. 3) THE AMOUNT DUE FROM CATASTROPHIC FINANCIAL ASSISTANCE APPLICANTS IS CAPPED AT 50% OF THEIR DOCUMENTED AND VERIFIED ANNUAL INCOME PLUS THE AMOUNT THE PATIENT'S LIQUID ASSETS GREATER THAN $10,000 4) WE WILL ALLOW PAYMENT OF THIS CAPPED AMOUNT OVER A PERIOD OF UP TO 10 YEARS, OR UP TO 15 YEARS WITH MANAGEMENT'S APPROVAL. 5) THESE PAYMENTS WILL BE TREATED AS LONG-TERM, INTEREST FREE PAYMENT AGREEMENTS AND REQUIRE A WRITTEN AGREEMENT.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 13 Facility A, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility A, 1 - FACILITY REPORTING GROUP A. PERSONS OR FAMILIES THAT QUALIFY FOR MEDICAID, FOOD STAMPS, AND OTHER INDIGENT CARE PROGRAMS THAT CAN BE AND ARE INDEPENDENTLY VERIFIED ARE DEEMED TO MEET THE FINANCIAL ASSISTANCE GUIDELINES, AS WILL ACCOUNTS IDENTIFIED THROUGH TOOLS OR PROGRAMS WHICH PROVIDE REASONABLE ASSURANCE THAT THE OBLIGATION MEETS OUR FINANCIAL ASSISTANCE GUIDELINES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>18</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MEDICAL CENTER PHARMACY OF BG</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>825 2ND STREET</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>PHARMACY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MEDEQUIP</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>825 2ND ST</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>DURABLE MEDICAL EQUIPMENT</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>TOMORROW'S WOMAN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>523 PARK STREET SUITE B</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>DUABLE MEDICAL EQUIPMENT</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MEDICAL CENTER EMS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>210 E THIRD AVE</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>EMERGENCY MEDICAL SERVICES</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>CAL TURNER REHAB &amp; SPECIALTY CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>456 BURNLEY ROAD</AddressLine1Txt>
            <CityNm>SCOTTSVILLE</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42164</ZIPCd>
          </USAddress>
          <FacilityTxt>REHAB &amp; SPECIALTY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MED CENTER HEALTH GENERAL SURGERY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>825 SECOND AVENUE EAST SUITE C1</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>GENERAL SURGERY PHYSICIAN CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PRIMARY CARE SCOTTSVILLE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>466 BURNLEY RD</AddressLine1Txt>
            <CityNm>SCOTTSVILLE</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42164</ZIPCd>
          </USAddress>
          <FacilityTxt>PRIMARY CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MED CENTER HEALTH NEUROLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>350 PARK STREET 206-A</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>NEUROLOGY PHYSICIAN CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MED CENTER HEALTH RADIOLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>250 PARK STREET</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>IMAGING/RADIOLOGY CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MEDICAL CENTER HOME CARE PROGRAM</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1953 SCOTTSVILLE RD 200</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42104</ZIPCd>
          </USAddress>
          <FacilityTxt>HOME HEALTH CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MEDICAL CENTER PSYCHIATRY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>350 PARK STREET 204</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>PSYCHIATRIC PHYSICIAN CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PRIMARY CARE FRANKLIN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1020 SOUTH MAIN STREET</AddressLine1Txt>
            <CityNm>FRANKLIN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42134</ZIPCd>
          </USAddress>
          <FacilityTxt>PRIMARY CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PRIMARY CARE CAVERNA</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1495 SOUTH DIXIE STREET</AddressLine1Txt>
            <CityNm>HORSE CAVE</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42749</ZIPCd>
          </USAddress>
          <FacilityTxt>PRIMARY CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PRIMARY CARE MUNFORDVILLE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1134 MAIN ST</AddressLine1Txt>
            <CityNm>MUNFORDVILLE</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42765</ZIPCd>
          </USAddress>
          <FacilityTxt>PRIMARY CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PRIMARY CARE RUSSELLVILLE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1719 NASHVILLE STREET SUITE C</AddressLine1Txt>
            <CityNm>RUSSELLVILLE</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42276</ZIPCd>
          </USAddress>
          <FacilityTxt>PRIMARY CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PRIMARY CARE AUBURN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>128 SUGAR MAPLE DRIVE</AddressLine1Txt>
            <CityNm>AUBURN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42206</ZIPCd>
          </USAddress>
          <FacilityTxt>PRIMARY CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PRIMARY CARE FOUNTAIN RUN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>47 AKERSVILLE RD</AddressLine1Txt>
            <CityNm>FOUNTAIN RUN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42133</ZIPCd>
          </USAddress>
          <FacilityTxt>PRIMARY CARE CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MEDICAL CENTER HEALTH &amp; WELLNESS CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>348 COLLEGE STREET SUITE 180</AddressLine1Txt>
            <CityNm>BOWLING GREEN</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>42101</ZIPCd>
          </USAddress>
          <FacilityTxt>COMMUNITY WELLNESS CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 3c DETERMINING ELIGIBILITY</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER (TMC) PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. LIQUID ASSETS IN EXCESS OF $10,000 ARE INCLUDED AS INCOME. PATIENTS OR GUARANTORS WHOSE INCOME IS LESS THAN 200% OF FEDERAL POVERTY LIMITS ARE ELIGIBLE FOR FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS LIMITED TO PATIENTS OR GUARANTORS WHOSE INCOME IS GREATER THAN 200% OF FEDERAL POVERTY LIMITS BUT LESS THAN OR EQUAL TO 400% OF FEDERAL POVERTY LIMITS. LIQUID ASSETS IN EXCESS OF $10,000 ARE INCLUDED AS INCOME. SEE THE NARRATIVES FOR LINES 13B AND 13H FOR MORE DETAIL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 3 BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER (TMC) HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN FINANCIAL ASSISTANCE, CANDIDATES MUST COOPERATE FULLY. IN ADDITION, TMC EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING OPTIONS FOR FINANCIAL ASSISTANCE. FOR THESE REASONS, TMC BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY, AND THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS NEGLIGIBLE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 9b DEBT COLLECTION PRACTICES</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER (TMC) PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. TMC DOES NOT PURSUE THE COLLECTION OF AMOUNTS DETERMINED TO BE TRADITIONAL FINANCIAL ASSISTANCE. BECAUSE TMC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL ASSISTANCE, REVENUE IS NOT RECORDED FOR SUCH SERVICES. THESE AMOUNTS ARE EXCLUDED FROM NET PATIENT SERVICE REVENUE. TMC MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF FINANCIAL ASSISTANCE THEY PROVIDE. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THEIR FINANCIAL ASSISTANCE POLICY. OTHER UNCOMPENSATED CARE RELATES PRINCIPALLY TO CONTRACTUAL ALLOWANCES FOR GOVERNMENT PAYERS, DISCOUNTS TAKEN BY COMMERCIAL PAYERS, AND BAD DEBTS. TMC PROVIDES SERVICES TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES OR WHO ARE UNINSURED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>A COST ACCOUNTING SYSTEM WAS USED FOR CALCULATIONS ON IRS WORKSHEETS 1 AND 3. THE COSTS RELATED TO MEDICAID PATIENTS WERE DETERMINED USING A COST ACCOUNTING SYSTEM. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part II Community Building Activities</FormAndLineReferenceDesc>
        <ExplanationTxt>WE ARE DEDICATED TO SERVING OUR COMMUNITY, BY KEEPING IT HEALTHY AND EARNING TRUST. AS PART OF OUR COMMITMENT, WE GIVE BACK FINANCIALLY INCLUDING FINANCIAL ASSISTANCE. WE EXPAND ACCESS TO CARE WITH MORE PROVIDERS, SPECIALTIES, AND TELEMEDICINE OPPORTUNITIES. WE ADDRESSED THE CRITICAL NEED FOR PHYSICIANS THROUGH OUR GRADUATE MEDICAL EDUCATION PROGRAM AND THE UK COLLEGE OF MEDICINE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER (TMC) HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH TMC DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED MARCH 31, 2025. HOWEVER, TMC INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THE HOSPITAL ELECTED TO EARLY ADOPT ASU 2011-07 ACCORDINGLY, BAD DEBT EXPENSE IS REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AN OPERATING EXPENSE FOR FINANCIAL REPORTING PURPOSES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 8 Community benefit &amp; methodology for determining medicare costs</FormAndLineReferenceDesc>
        <ExplanationTxt>COSTS REPORTED ON LINE 6 ARE OBTAINED FROM THE COST ACCOUNTING SYSTEM, WHICH ARE BASED UPON COST ACCOUNTING STANDARD PRINCIPALS OF ALLOCATING DIRECT AND INDIRECT EXPENSES TO SERVICES PERFORMED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16a FAP website</FormAndLineReferenceDesc>
        <ExplanationTxt>A - THE MEDICAL CENTER AT BOWLING GREEN: Line 16a URL: HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16b FAP Application website</FormAndLineReferenceDesc>
        <ExplanationTxt>A - THE MEDICAL CENTER AT BOWLING GREEN: Line 16b URL: HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16c FAP plain language summary website</FormAndLineReferenceDesc>
        <ExplanationTxt>A - THE MEDICAL CENTER AT BOWLING GREEN: Line 16c URL: HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2 Needs assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER IS BUILT UPON THE FOUNDATION OF SERVING OUR COMMUNITY, DAY IN AND DAY OUT, WITH QUALITY DEPENDABLE HEALTHCARE. THE MEDICAL CENTER'S CHNA AND STRATEGIC IMPLEMENTATION PLANS ARE POSTED AT: HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3 Patient education of eligibility for assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>UPON REGISTRATION, PATIENTS ARE PROVIDED A PLAIN LANGUAGE SUMMARY OF OUR FINANCIAL ASSISTANCE POLICY WITH INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE AND CONTACT INFORMATION FOR ADDITIONAL ASSISTANCE. SIGNAGE AND BROCHURES DESCRIBING FINANCIAL ASSISTANCE POLICIES ARE AVAILABLE. ADDITIONALLY, THE POLICY AND APPLICATION ARE PUBLICLY AVAILABLE ON THE HOSPITAL'S WEBSITE. UNINSURED PATIENTS DISCUSS PAYMENT OPTIONS INCLUDING FINANCIAL ASSISTANCE WITH FINANCIAL COUNSELORS WHO INFORM THESE PATIENTS ABOUT OUR POLICY AND ASSIST THEM IN APPLYING IF NECESSARY. SUBSEQUENT PATIENT STATEMENTS RECEIVED BY THE PATIENT CONTAIN INFORMATION ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4 Community information</FormAndLineReferenceDesc>
        <ExplanationTxt>BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (THE MEDICAL CENTER) IS DESIGNATED AS A REGIONAL REFERRAL CENTER BY THE BARREN RIVER REGIONAL HEALTH PLANNING COUNCIL, AN AGENCY OF THE COMMONWEALTH OF KENTUCKY. THE MEDICAL CENTER SERVES PATIENTS THROUGHOUT AN AREA COMPRISING TEN COUNTIES, CALLED THE BARREN RIVER AREA DEVELOPMENT DISTRICT (THE DISTRICT) IN SOUTH-CENTRAL KENTUCKY. THE POPULATION OF THE MEDICAL CENTER'S PRIMARY SERVICE AREA IS APPROXIMATELY 300,000 PEOPLE. THE COMMUNITY IS GROWING, AND WE SERVE A GROWING UNINSURED AND UNDERINSURED POPULATION. THE NUMBER OF RESIDENTS IN THE DISTRICT IN HOUSEHOLDS BELOW THE FEDERAL POVERTY GUIDELINES VARY BY COUNTY WITH AN AVERAGE RANGING FROM 15%-21% PER COUNTY LIVING IN POVERTY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5 Promotion of community health</FormAndLineReferenceDesc>
        <ExplanationTxt>AS PART OF COMMONWEALTH HEALTH CORPORATION, TMC IS PATIENT-FOCUSED, QUALITY-DRIVEN, AND MISSION-LED. OUR MISSION IS TO CARE FOR PEOPLE AND IMPROVE THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. WE COMBINE STATE-OF-THE-ART TECHNOLOGY, UNSURPASSED PERSONAL CARE, AND THE FINEST HEALTHCARE PROFESSIONALS TO ENSURE EACH VISIT IS THE VERY BEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 6 Affiliated health care system</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER IS OWNED AND CONTROLLED BY COMMONWEALTH HEALTH CORPORATION, A RELATED 501(C)(3) ORGANIZATION. COMMONWEALTH HEALTH CORPORATION (CHC) IS A HOLDING COMPANY FOR A TOTAL OF TWELVE NONPROFIT CORPORATIONS AND A PARTNERSHIP (COLLECTIVELY, THE AFFILIATES) ENGAGED IN VARIOUS ASPECTS OF THE HEALTH CARE INDUSTRY. CHC OWNS AND OPERATES MULTIPLE PHYSICIAN PRACTICES, WHICH ARE DESIGNED TO ATTRACT AND RETAIN HIGHLY SKILLED PHYSICIANS IN SPECIALTIES THAT SUPPORT THE MISSION OF CHC AND ITS AFFILIATES. IN ADDITION, CHC OPERATES AND PROVIDES VARIOUS CORPORATE SUPPORT SERVICES INCLUDING PATIENT BILLING, COLLECTIONS, ACCOUNTING, MATERIALS MANAGEMENT, ENGINEERING, SECURITY, HUMAN RESOURCES, INFORMATION SYSTEMS, AND ADMINISTRATIVE SUPPORT TO ITS AFFILIATES. CHC HAS ESTABLISHED VARIOUS DIVISIONS FOR ITS OPERATIONS, INCLUDING THE NONPROFIT ORGANIZATIONS DESCRIBED BELOW (IN ADDITION TO TMC) AND OTHER NONPROFIT AND FOR-PROFIT CORPORATIONS AND PARTNERSHIPS. BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (THE MEDICAL CENTER): ------------------------------------------------------------------------------------------------------------------------------------ BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (THE MEDICAL CENTER) IS A NONPROFIT KENTUCKY CORPORATION THAT OPERATES A 373-BED HOSPITAL FACILITY IN BOWLING GREEN, KENTUCKY UNDER THE NAME THE MEDICAL CENTER AT BOWLING GREEN AND SINCE OCTOBER 1996, A 25-BED CRITICAL ACCESS HOSPITAL AND 110 BED NURSING HOME FACILITY IN SCOTTSVILLE, KENTUCKY, UNDER THE NAME THE MEDICAL CENTER AT SCOTTSVILLE. IN ADDITION, SINCE JANUARY 2016, THE CORPORATION HAS OPERATED A 25-BED CRITICAL ACCESS ACUTE CARE HOSPITAL IN HORSE CAVE, KENTUCKY UNDER THE NAME THE MEDICAL CENTER AT CAVERNA. THE THREE FACILITIES ARE PART OF ONE CORPORATION BUT ARE SEPARATELY LICENSED BY THE STATE OF KENTUCKY. THE MEDICAL CENTER AT BOWLING GREEN IS THE SOLE MEMBER OF MEDICAL CENTER EMS, LLC (EMS), MEDICAL CENTER PHARMACY OF BOWLING GREEN, LLC (RIVERSIDE PHARMACY) AND ENSPIRE QUALITY PARTNERS, LLC (MED CENTER HEALTH PARTNERS). EMS PROVIDES AMBULANCE SERVICES IN WARREN COUNTY, KENTUCKY. RIVERSIDE OFFERS RETAIL PHARMACY SERVICES IN BOWLING GREEN, KY. MED CENTER HEALTH PARTNERS IS A CLINICALLY INTEGRATED NETWORK OF HEALTHCARE PROVIDERS, WORKING TOGETHER UNDER A PHYSICIAN-LED STRUCTURE TO IMPROVE POPULATION HEALTH, IMPROVE PATIENT EXPERIENCE AND REDUCE THE COST OF HEALTHCARE. THE CORPORATION IS BOTH THE LIMITED PARTNER AND A GENERAL PARTNER IN THE MEDICAL PLAZA PARTNERS, LLP WHICH PROVIDES ON-CAMPUS SPACE FOR HOSPITAL DEPARTMENTS AND OTHER NON-AFFILIATE MEDICAL-RELATED SERVICES. TOGETHER WITH ANOTHER AREA NON-PROFIT ACUTE CARE HOSPITAL CORPORATION, TMC IS AN EQUAL OWNER OF THE BARREN RIVER REGIONAL CANCER CENTER, INC., AN OUTPATIENT RADIATION THERAPY CARE SERVICE LOCATED IN GLASGOW, KENTUCKY. THE MEDICAL CENTER AT SCOTTSVILLE OPERATES TWO RURAL HEALTH CLINICS, ONE IN SCOTTSVILLE, KY AND ONE IN FOUNTAIN RUN, KY. THE MEDICAL CENTER AT CAVERNA OPERATES TWO RURAL HEALTH CLINICS, ONE IN MUNFORDVILLE, KY AND ONE IN HORSE CAVE, KY. EFFECTIVE APRIL 1, 2024, THE BOARD OF DIRECTORS OF THE MEDICAL CENTER AT FRANKLIN, INC. EXECUTED A RESOLUTION TO DISSOLVE THE MEDICAL CENTER AT FRANKLIN, INC. AND TRANSFER ALL ASSETS AND LIABILITIES TO THE BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL. THE BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CONTINUES TO OPERATE THE MEDICAL CENTER AT FRANKLIN (MCF) AS A HOSPITAL IN THE COMMUNITY OF FRANKLIN, SIMPSON COUNTY, KENTUCKY. MCF IS A MEDICARE DESIGNATED CRITICAL ACCESS HOSPITAL OFFERING ACUTE CARE INPATIENT AND OUTPATIENT PROGRAMS IN ITS 25 BED ACUTE CARE FACILITY. MCF ALSO OPERATES A RURAL HEALTH CLINIC IN FRANKLIN, KY. EFFECTIVE APRIL 1, 2024, THE BOARD OF DIRECTORS OF THE MEDICAL CENTER AT CLINTON COUNTY, INC. D/B/A THE MEDICAL CENTER AT ALBANY EXECUTED A RESOLUTION TO DISSOLVE THE MEDICAL CENTER AT CLINTON COUNTY, INC. AND TRANSFER ALL ASSETS AND LIABILITIES TO THE BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL. THE BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CONTINUES TO OPERATE THE MEDICAL CENTER AT ALBANY AS A 42-BED ACUTE CARE HOSPITAL THAT EARNS REVENUE BY PROVIDING INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES IN CLINTON COUNTY AND SURROUNDING COUNTIES IN KENTUCKY. Effective July 1, 2024, The Medical Center acquired certain assets of Logan Memorial Hospital, LLC and affiliates, an acute care hospital in Russellville, KY. This 75-bed, acute care hospital now operates as The Medical Center at Russellville. The Medical Center at Russellville operates two rural health clinics, one in Auburn, KY and one in Russellville, KY. COMMONWEALTH HEALTH FREE CLINIC, INC.: ------------------------------------------------------------ COMMONWEALTH HEALTH FREE CLINIC, INC. (CHFC) WAS ORGANIZED TO OPERATE A CLINIC, WHICH PROVIDES BASIC MEDICAL AND DENTAL DIAGNOSTIC AND TREATMENT SERVICES FOR CHARITABLE PURPOSES FOR THE UNINSURED AND UNDERINSURED OF SOUTH-CENTRAL KENTUCKY AND ALSO SERVES INDIVIDUALS WHO MAY BE COVERED BY SOME FORM OF INSURANCE, BUT WHO ARE UNABLE TO ACCESS A PROVIDER FOR ACUTE OR CHRONIC HEALTHCARE ISSUES. THE CLINIC OFFERS SERVICES INCLUDING NON-EMERGENCY CLINICAL SERVICES, DENTISTRY, COMMUNITY HEALTH EDUCATION AND COUNSELING, DISEASE/CONDITION SPECIFIC EDUCATION AND COUNSELING, AND ACCESS TO PHARMACEUTICALS. COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.: --------------------------------------------------------------------------- COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC IS A LONG-TERM ACUTE CARE HOSPITAL THAT OPERATES AS A HOSPITAL WITHIN A HOSPITAL BY LEASING BEDS FROM THE MEDICAL CENTER ON ITS BOWLING GREEN CAMPUS. IT IS AN ACUTE CARE HOSPITAL FOR THOSE PATIENTS REQUIRING AN EXTENDED HOSPITAL STAY (ANTICIPATED LENGTH OF STAY BETWEEN 18-35 DAYS) AND GENERALLY HAVING COMPLEX OR CHRONIC MEDICAL CONDITIONS. COMMONWEALTH HEALTH FOUNDATION: ------------------------------------------------------- CHC ENDORSED THE ESTABLISHMENT OF COMMONWEALTH HEALTH FOUNDATION (THE FOUNDATION) FOR THE PURPOSE OF FOSTERING, SUPPORTING, AND INITIATING ACTIVITIES FOR THE CHC AND THE MEDICAL CENTER AND/OR AFFILIATED NON-PROFIT 501(C)(3) ORGANIZATIONS. THE FOUNDATION BUILDS RELATIONSHIPS THAT INSPIRE CHARITABLE GIVING IN SUPPORT OF CHC'S MISSION TO CARE FOR PEOPLE AND IMPROVE THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. BLUEGRASS OUTPATIENT CENTER: ---------------------------------------------- SINCE 2008, CHC HAS BEEN THE SOLE OWNER OF BLUEGRASS OUTPATIENT CENTER OF BOWLING GREEN, LLC (BLUEGRASS). BLUEGRASS PROVIDES COMPREHENSIVE OUTPATIENT REHABILITATION THERAPY SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="IRS990ScheduleI" softwareId="24020961" softwareVersionNum="2024v5.1">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Clinton County</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>100 SOUTH CROSS STREET</AddressLine1Txt>
          <CityNm>ALBANY</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42602</ZIPCd>
        </USAddress>
        <RecipientEIN>610972600</RecipientEIN>
        <IRCSectionDesc>GOV'T</IRCSectionDesc>
        <CashGrantAmt>26250</CashGrantAmt>
        <PurposeOfGrantTxt>EMS</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Scholarships</GrantTypeTxt>
        <RecipientCnt>2</RecipientCnt>
        <CashGrantAmt>12052</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds</FormAndLineReferenceDesc>
        <ExplanationTxt>BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION IS FREQUENTLY ASKED TO CONTRIBUTE TO A VARIETY OF ORGANIZATIONS AND FUNDRAISING PROJECTS. IT IS THE HOSPITAL'S GOAL TO BE A SUPPORTIVE CITIZEN AND, WHEN PRACTICAL AND POSSIBLE, TO MAKE REASONABLE CONTRIBUTIONS WHICH ARE BENEFICIAL TO THE COMMUNITY AND PARALLEL TO OUR EXEMPT PURPOSE. The Foundation actively monitors scholarship recipients through a combination of regular progress reports from the recipient's educational institution, academic transcript reviews, and, when necessary, direct communication with the student. These measures ensure compliance with the scholarship's eligibility requirements, such as maintaining a minimum GPA and full-time enrollment status.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="24020961" softwareVersionNum="2024v5.1">
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MS CONNIE D SMITH</PersonNm>
        <TitleTxt>PRESIDENT / CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>1071288</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>282549</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>109015</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>23353</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1486205</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR WILLIAM MOSS</PersonNm>
        <TitleTxt>DIRECTOR / PHYSICIAN / CHIEF MEDICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>377083</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>11703</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10350</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22353</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>421489</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR MOHAMMED KAZIMUDDIN</PersonNm>
        <TitleTxt>DIRECTOR / PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>333656</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1111</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3584</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>338351</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MS MICHELE W LAWLESS</PersonNm>
        <TitleTxt>EXECUTIVE VICE PRESIDENT / CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>533495</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>6828</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>107269</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>3880</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>651472</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MR DAVID GRAY</PersonNm>
        <TitleTxt>EXECUTIVE VICE PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>438718</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>15132</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>10350</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>39154</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>503354</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MR WADE STONE</PersonNm>
        <TitleTxt>EXECUTIVE VICE PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>462701</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>3034</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>62114</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>18257</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>546106</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MS KATRINA WOOD</PersonNm>
        <TitleTxt>EVP / CHIEF NURSING OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>312589</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>4442</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>55616</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>33509</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>406156</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MR ERIC HAGAN</PersonNm>
        <TitleTxt>VP OF RURAL HOSPITALS</TitleTxt>
        <BaseCompensationFilingOrgAmt>303221</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>7093</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>62893</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22774</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>395981</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR DARIN L PASSER</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>634759</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>3612</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10350</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>37307</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>686028</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR DANIEL L DAVIS</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>590269</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>3612</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10350</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>33636</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>637867</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR CATRINIA DRUEN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>497759</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1087</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10350</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10752</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>519948</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR SHAFIA RUBEEN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>377187</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1186</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10638</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25856</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>414867</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR JOSEPH GRAU</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>362443</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>14370</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>52875</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22156</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>451844</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>CERTAIN EXECUTIVES OF COMMONWEALTH HEALTH CORPORATION PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PLAN. THE CURRENT YEAR INCREASE IN THE ACCRUED BENEFIT, AS ACTUARIALLY DETERMINED, IS REPORTED AS COMPENSATION. THE FOLLOWING ARE THE INDIVIDUALS PARTICIPATING IN THE PLAN AND THE CURRENT YEAR INCREASES REPORTED AS COMPENSATION: CONNIE SMITH $258,909 WADE STONE $ -0-</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CEO IS COMPENSATED BY COMMONWEALTH HEALTH CORPORATION (CHC), A RELATED ORGANIZATION. CHC USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK1" softwareId="24020961" softwareVersionNum="2024v5.1">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COUNTY OF WARREN KENTUCKY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>616000710</BondIssuerEIN>
        <CUSIPNum>934864AC3</CUSIPNum>
        <BondIssuedDt>2012-08-01</BondIssuedDt>
        <IssuePriceAmt>44126652</IssuePriceAmt>
        <PurposeDesc>SEE PART VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COUNTY OF WARREN KENTUCKY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>616000710</BondIssuerEIN>
        <CUSIPNum>934864BJ7</CUSIPNum>
        <BondIssuedDt>2021-02-10</BondIssuedDt>
        <IssuePriceAmt>44854001</IssuePriceAmt>
        <PurposeDesc>SEE PART VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COUNTY OF WARREN KENTUCKY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>616000710</BondIssuerEIN>
        <CUSIPNum>934864CP2</CUSIPNum>
        <BondIssuedDt>2024-02-07</BondIssuedDt>
        <IssuePriceAmt>164982949</IssuePriceAmt>
        <PurposeDesc>SEE PART VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>44126652</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>272944</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>16302725</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>27550983</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceedsAmt>44854001</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>380120</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>44473881</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2021</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <TotalProceedsAmt>164982949</TotalProceedsAmt>
        <CapitalizedInterestAmt>9689100</CapitalizedInterestAmt>
        <IssuanceCostsFromProceedsAmt>1307286</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>27325123</CapitalExpendituresAmt>
        <UnspentAmt>126661440</UnspentAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>false</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>true</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>false</EngageBondCounselResearchInd>
        <PrivateBusUseByOthersPct>0.0004</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0007</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0011</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>true</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>false</EngageBondCounselResearchInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>true</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>false</EngageBondCounselResearchInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <TermOfHedgePct>0</TermOfHedgePct>
        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <TermOfGICPct>0</TermOfGICPct>
        <RegulatorySafeHarborStsfdInd>false</RegulatorySafeHarborStsfdInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <TermOfHedgePct>0</TermOfHedgePct>
        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <TermOfGICPct>0</TermOfGICPct>
        <RegulatorySafeHarborStsfdInd>false</RegulatorySafeHarborStsfdInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <TermOfHedgePct>0</TermOfHedgePct>
        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <TermOfGICPct>0</TermOfGICPct>
        <RegulatorySafeHarborStsfdInd>false</RegulatorySafeHarborStsfdInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column (f) BOND A - DESCRIPTION OF PURPOSE</FormAndLineReferenceDesc>
        <ExplanationTxt>TO (1) FUND CONSTRUCTION OF THE MEDICAL CENTER-WKU HEALTH SCIENCE EDUCATION BUILDING, (2) REFUND A PORTION OF THE 2008 BONDS ISSUED ON MARCH 20, 2008, (3) AND TO PAY THE COSTS OF ISSUING THE SERIES 2012 BONDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column (f) BOND B - DESCRIPTION OF PURPOSE</FormAndLineReferenceDesc>
        <ExplanationTxt>TO (1) DEFEASE THE REMAINING OUTSTANDING SERIES 2015 AND 2017 BONDS, AND (2) TO PAY THE COSTS OF ISSUING THE BONDS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column (f) BOND C - DESCRIPTION OF PURPOSE</FormAndLineReferenceDesc>
        <ExplanationTxt>To (a) finance or reimburse for all or a portion of the costs of the acquisition, construction, installation and equipping of a five-story patient care tower and related facilities and improvements adjacent to the existing hospital facilities, (b) finance or reimburse for all or a portion of the costs of the acquisition, construction, installation, equipping and improvement of health care equipment and facilities, (c) pay capitalized interest on the Bonds and (d) pay costs of issuance of the Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part IV, Line 2c ARBITRAGE CALCULATIONS</FormAndLineReferenceDesc>
        <ExplanationTxt>A rebate calculation is performed every 5 years for the 2012 and 2021 bonds. The last rebate calculation was issued in August 2023 for the July 31, 2023 computation date. A rebate calculation was performed in May 2025 for the April 1, 2025 computation date.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="24020961" softwareVersionNum="2024v5.1">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>ENTITIES OWNED BY Dr Mohammed Kazimuddin (SEE DESCRIPTION OF TRANSACTION)</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>ENTITIES OWNED BY Dr. Kazimuddin. Dr. SERVES AS AN EMPLOYEE/BOARD MEMBER OF BGWCCHC.</RelationshipDescriptionTxt>
        <TransactionAmt>20233000</TransactionAmt>
        <TransactionDesc>DURING THE TAX YEAR ENDED MARCH 31, 2025, BGWCCHC PURCHASED REAL PROPERTY AND EQUIPMENT FROM KAZIMUDDIN MEDICAL PROPERTIES, WESTERN KENTUCKY HEART &amp; LUNG PROPERTIES, WESTERN KENTUCKY HEART &amp; LUNG MEDICAL EQUIPMENT, AND WESTERN KENTUCKY HEART &amp; LUNG ASSOCIATES. THE PURCHASE PRICE WAS AT FAIR MARKET VALUE BASED ON AN INDEPENDENT APPRAISAL. KAZIMUDDIN MEDICAL PROPERTIES, WESTERN KENTUCKY HEART &amp; LUNG PROPERTIES, WESTERN KENTUCKY HEART &amp; LUNG MEDICAL EQUIPMENT, AND WESTERN KENTUCKY HEART &amp; LUNG ASSOCIATES OWNED BY DR. KAZIMUDDIN.</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>KAP LAND HOLDINGS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>KAP LAND HOLDINGS IS OWNED BY DR. TRACY CROSS. DR. CROSS IS A BOARD MEMBER OF CHC.</RelationshipDescriptionTxt>
        <TransactionAmt>1625000</TransactionAmt>
        <TransactionDesc>DURING THE TAX YEAR ENDED MARCH 31, 2025, BGWCCHC PURCHASED REAL ESTATE FROM KAP LAND HOLDINGS. THE PURCHASE PRICE WAS AT FAIR MARKET VALUE BASED ON AN INDEPENDENT APPRAISAL. KAP LAND HOLDINGS IS OWNED BY DR. CROSS.</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>PARK MEDICAL PLAZA LLC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>PARK MEDICAL PLAZA IS OWNED BY DR. KAL SAHETYA. DR. SAHETYA IS A BOARD MEMBER OF CHC.</RelationshipDescriptionTxt>
        <TransactionAmt>10000000</TransactionAmt>
        <TransactionDesc>DURING THE TAX YEAR ENDED MARCH 31, 2025, BGWCCHC PURCHASED REAL ESTATE AND EQUIPMENT FROM PARK MEDICAL PLAZA. THE PURCHASE PRICE WAS AT FAIR MARKET VALUE BASED ON AN INDEPENDENT APPRAISAL. PARK MEDICAL PLAZA IS OWNED BY DR. SAHETYA.</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="24020961" softwareVersionNum="2024v5.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4 Lines 4A and 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL D/B/A THE MEDICAL CENTER OF BOWLING GREEN, THE MEDICAL CENTER OF ALBANY, THE MEDICAL CENTER OF CAVERNA, THE MEDICAL CENTER OF FRANKLIN, THE MEDICAL CENTER OF RUSSELLVILLE, AND THE MEDICAL CENTER OF SCOTTSVILLE (THE MEDICAL CENTER) IS THE PREMIER HEALTHCARE GROUP IN SOUTH-CENTRAL KENTUCKY. AS A TEACHING HOSPITAL, THE MEDICAL CENTER OFFERS THE WIDEST RANGE OF SPECIALTIES AND THE STRONGEST PARTNERSHIPS WITH THE AREA'S MOST RESPECTED EDUCATIONAL INSTITUTIONS. OUR PHYSICIANS STRIVE TO MAINTAIN THE HIGHEST-LEVEL ACCREDITATIONS AND EMPLOY THE MOST INNOVATIVE APPROACHES TO HEALTHCARE. THE MEDICAL CENTER'S PROFESSIONAL STAFF INCLUDES PHYSICIANS WHO ARE ENGAGED IN THE PRACTICE OF MEDICINE AND WHO REPRESENT MULTIPLE SPECIALTIES, INCLUDING FAMILY PRACTICE AND EMERGENCY CARE. THE STAFF ALSO INCLUDES NURSES, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPISTS, PSYCHOLOGISTS, RESPIRATORY THERAPISTS, NUTRITIONISTS, AND OTHERS. USING AN INTERDISCIPLINARY TEAM APPROACH, THE STAFF WORK COLLABORATIVELY TO PROVIDE PRIMARY OUTPATIENT CARE, RENDERED IN AN EMERGENCY ROOM AND OUTPATIENT SETTING, AND SECONDARY CARE CONSISTING OF INPATIENT SERVICES OF A GENERAL AND SPECIALIZED NATURE. THE MEDICAL CENTER FEATURES FULL-SERVICE EMERGENCY ROOMS THAT ARE AVAILABLE AND STAFFED WITH PHYSICIANS AND REGISTERED NURSES 24 HOURS A DAY, 7 DAYS A WEEK. SERVICES OFFERED AT THE MEDICAL CENTER INCLUDE: - ACUTE MEDICAL CARE - SKILLED MEDICAL CARE - INTENSIVE CARE, INCLUDING NEURO ICU, CARDIAC ICU, MEDICAL ICU, AND SURGICAL ICU WITH OPEN HEART RECOVERY - CATH LAB - PHARMACY - INTERVENTIONAL CARDIOLOGY - PHYSICAL THERAPY - LABORATORY, CLINICAL AND PATHOLOGY - RADIATION MEDICINE (INPATIENT/OUTPATIENT ONCOLOGY AND INPATIENT/OUTPATIENT CHEMO) - HOME HEALTH SERVICES - SURGICAL INPATIENT SERVICES, INCLUDING HYBRID SURGICAL PROCEDURES - SURGICAL OUTPATIENT SERVICES - EMERGENCY DEPARTMENT - OUTPATIENT SERVICES - RESPIRATORY THERAPY SERVICES - RADIOLOGY, INCLUDING MAMMOGRAPHY, DIAGNOSTIC X-RAY, NUCLEAR MEDICINE, CAT SCANNING, ULTRASOUND, CARDIOLOGY, POSITRON EMISSION TOMOGRAPHY, MRI - WOMEN'S SERVICES, INCLUDING LABOR &amp; DELIVERY, NURSERY, NICU, POSTPARTUM - ONCOLOGY SERVICES SIGNIFICANT PROGRAM SERVICE ACHIEVEMENTS DURING FISCAL YEAR 2025: DAYS OF ACUTE/SWING BED PATIENT CARE (INCLUDING NURSERY) 107,426 DAYS OF SKILLED NURSING CARE 38,953 OBSERVATION DAYS 14,357 BIRTHS 2,887 OPEN HEART PROCEDURES 432 SURGERIES 17,805 EMERGENCY ROOM VISITS 83,466 AMBULANCE RUNS 28,530</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 2a MANAGEMENT SERVICES AGREEMENT</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMONWEALTH HEALTH CORPORATION HAS A MANAGEMENT SERVICES AGREEMENT FOR BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION AND COMMONWEALTH REGIONAL SPECIALTY HOSPITAL. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 31-1118087.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a AND 15B - DETERMINING COMPENSATION</FormAndLineReferenceDesc>
        <ExplanationTxt>EMPLOYEE OFFICERS OF THIS ENTITY ARE EMPLOYEES OF COMMONWEALTH HEALTH CORPORATION. CHC USES INDEPENDENT CONSULTANTS TO ANNUALLY REVIEW COMPENSATION. COMPENSATION-RELATED DETERMINATIONS ARE CONDUCTED IN ACCORDANCE WITH APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE AND REGULATIONS TO QUALIFY FOR THE PRESUMPTION THAT THE COMPENSATION IS REASONABLE, INCLUDING BUT NOT LIMITED TO APPROVAL BY AN AUTHORIZED COMMITTEE OF THE BOARD OF DIRECTORS WHO DO NOT HAVE A CONFLICT OF INTEREST, OBTAINING AND RELYING ON APPROPRIATE DATA AS TO COMPARABILITY, AND CONCURRENT DOCUMENTATION OF THE BASIS FOR THE COMPENSATION DETERMINATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>ARTICLE 2 OF THE BYLAWS IDENTIFIES COMMONWEALTH HEALTH CORPORATION BOARD OF DIRECTORS AS THE MEMBER. ARTICLE 2 OF THE BYLAWS SAYS THE MEMBER SHALL APPOINT A NOMINATING COMMITTEE WHICH SHALL MEET AND DESIGNATE NOMINEES FOR ALL POSITIONS TO BE FILLED BY APPOINTMENT BY THE MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>BYLAWS OF THE CORPORATION SPECIFY THAT THE SOLE MEMBER SHALL APPOINT A NOMINATING COMMITTEE WHICH SHALL MEET AND DESIGNATE NOMINEES FOR BOARD DIRECTORSHIPS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BYLAWS MAY BE REVISED OR AMENDED BY AFFIRMATIVE VOTE OF TWO-THIRDS (2/3) OF THE BOARD, SUBJECT TO APPROVAL OF THE MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 IS SENT TO BOARD MEMBERS VIA SECURE EMAIL. EACH BOARD MEMBER RECEIVES ACCESS TO REVIEW THE FORM PRIOR TO THE DESIGNATED FILING DATE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMMONWEALTH HEALTH CORPORATION (CHC) (APPLICABLE TO THE CORPORATION AND/OR ITS AFFILIATES) CODE OF CONDUCT EXPLICITLY STATES MEMBERS OF THE BOARD, ADMINISTRATION, THE MEDICAL STAFF, AND ALL EMPLOYEES ARE EXPECTED TO AVOID CONFLICTS OF INTEREST IN A TIMELY MANNER. ALL INDIVIDUALS SIGN AN ACKNOWLEDGEMENT UPON EMPLOYMENT THAT THEY HAVE RECEIVED A COPY OF THE CODE OF CONDUCT, ARE FAMILIAR WITH ITS CONTENT, AND UNDERSTAND THEIR RESPONSIBILITIES TO AVOID NON-COMPLIANT ACTIVITY. CHC'S REGULATORY COMPLIANCE AND COMPENSATION COMMITTEE (RCC) REVIEWS AND APPROVES ALL CONTRACTS BETWEEN CHC AND/OR ITS AFFILIATES AND DISQUALIFIED ENTITIES. THE REVIEW IS DESIGNED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST BY BOARD MEMBERS AND/OR OFFICERS. RCC MEMBERS ARE PROHIBITED FROM TAKING PART IN DECISIONS REGARDING TRANSACTIONS WITH WHICH HE/SHE HAS A CONFLICT OF INTEREST. ANNUALLY, WRITTEN INQUIRY IS MADE - BY QUESTIONNAIRE - OF BOARD MEMBERS AND OFFICERS SEEKING DISCLOSURE OF CONFLICTS OF INTEREST OR INFORMATION THAT RELATES TO FAMILY MEMBERS. TRANSACTIONS ARISING ARE REVIEWED BY MANAGEMENT AS THEY OCCUR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ONLY MADE AVAILABLE IF REQUIRED, AND IN THE MANNER REQUIRED, BY A GOVERNING AGENCY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 11d Other Miscellaneous Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>CAFETERIA - Total Revenue: 2059870, Related or Exempt Function Revenue: 2059870, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>COLLECTION AGENCY FEES - Total Expense: 2883570, Program Service Expense: 2883570, Management and General Expenses: 0, Fundraising Expenses: 0; MEDICAL CONSULTING FEES - Total Expense: 26207705, Program Service Expense: 26207705, Management and General Expenses: 0, Fundraising Expenses: 0; OTHER PROFESSIONAL FEES - Total Expense: 15559813, Program Service Expense: 15559813, Management and General Expenses: 0, Fundraising Expenses: 0; LAB FEES - Total Expense: 103396, Program Service Expense: 103396, Management and General Expenses: 0, Fundraising Expenses: 0; CONTRACT FEES - Total Expense: 18240761, Program Service Expense: 18240761, Management and General Expenses: 0, Fundraising Expenses: 0; BILLING FEES - Total Expense: 5782161, Program Service Expense: 0, Management and General Expenses: 5782161, Fundraising Expenses: 0; AGENCY NURSING FEES - Total Expense: 11488114, Program Service Expense: 11488114, Management and General Expenses: 0, Fundraising Expenses: 0;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN MINIMUM PENSION LIABILITY - 2010575; CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST - 627; OTHER COMPONENTS OF NET PERIODIC PENSION COSTS - 1355170; EXCESS OF FAIR VALUE OF NET ASSETS ACQUIRED LOGAN MEMORIAL - 3566403; Total - 6932775;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2c Change of Oversight Process or selection process</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="24020961" softwareVersionNum="2024v5.1">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MEDICAL CENTER PHARMACY OF BOWLING GREEN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>061778164</EIN>
        <PrimaryActivitiesTxt>PHARMACY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <TotalIncomeAmt>11928588</TotalIncomeAmt>
        <EndOfYearAssetsAmt>9131118</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MEDICAL CENTER EMS LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>562332847</EIN>
        <PrimaryActivitiesTxt>EMERG MED SVC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <TotalIncomeAmt>10135131</TotalIncomeAmt>
        <EndOfYearAssetsAmt>2195829</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ENSPIRE QUAILTY PARTNERS LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>464379627</EIN>
        <PrimaryActivitiesTxt>IMPROVE CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <TotalIncomeAmt>2547037</TotalIncomeAmt>
        <EndOfYearAssetsAmt>1977006</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMONWEALTH HEALTH CORPORATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>311118087</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMONWEALTH HEALTH FREE CLINIC INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>611292739</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHC INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMONWEALTH HEALTH FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>611362000</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHC INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMONWEALTH REGIONAL SPECIALTY HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>542142034</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHC INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER OF FRANKLIN INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>611362001</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHC INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER AT CLINTON CO INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>811312058</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHC INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDICAL PLAZA PARTNERS LTD</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>800 PARK STREET</AddressLine1Txt>
          <CityNm>BOWLING GREEN</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>42101</ZIPCd>
        </USAddress>
        <EIN>611080800</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Excluded</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>254816</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>588021</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.9226</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MEDICAL PLAZA PARTNERS LTD</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>287579</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>