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        <Title>NURSE ANESTHETIST</Title>
        <AverageHoursPerWeek>40.0</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>196436</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>16773</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>REIDTHOMAS</NamePerson>
        <Title>NURSE ANESTHETIST</Title>
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        <ReportableCompFromOrganization>190404</ReportableCompFromOrganization>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>PETIKJASON P</NamePerson>
        <Title>CEO CUSTER REGIONAL HOSPITAL</Title>
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        <ReportableCompFromOrganization>125771</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>26860</OtherCompensation>
      </Form990PartVIISectionA>
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      <TotalReportableCompFrmRltdOrgs>3476276</TotalReportableCompFrmRltdOrgs>
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        </NameOfContractor>
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            <State>AR</State>
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        </AddressOfContractor>
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      <ContractorCompensation>
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          <AddressUS>
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            <City>MILWAUKEE</City>
            <State>WI</State>
            <ZIPCode>53201</ZIPCode>
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      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>DIAGNOSTIC MEDICAL SYSTEMS HEALTH T</NamePerson>
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          <AddressUS>
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            <State>ND</State>
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      <ContractorCompensation>
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          <AddressUS>
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            <State>PA</State>
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            <State>CA</State>
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          </AddressUS>
        </AddressOfContractor>
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      <AllOtherContributions>115010</AllOtherContributions>
      <TotalContributions>179284</TotalContributions>
      <ProgramServiceRevenue>
        <Description>ACUTE CARE HOSPITAL IN AND OUT PATIENTS</Description>
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      <ProgramServiceRevenue>
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      </ProgramServiceRevenue>
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        <RelatedOrExemptFunctionIncome>2160000</RelatedOrExemptFunctionIncome>
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      <ProgramServiceRevenue>
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        <RelatedOrExemptFunctionIncome>1791000</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>PHYSICIAN CLINICS</Description>
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      <RoyaltiesRevenue>
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      <NetGainOrLossInvestments>
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      </NetGainOrLossInvestments>
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      <NetIncomeFromGaming>
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      <NetIncomeOrLoss>
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      <TotalRevenue>
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        <ExclusionAmount>193396</ExclusionAmount>
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      <GrantsToDomesticOrgs>
        <Total>0</Total>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>1033437</Total>
        <ManagementAndGeneral>1033437</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>34345891</Total>
        <ProgramServices>28772052</ProgramServices>
        <ManagementAndGeneral>5573839</ManagementAndGeneral>
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      <PensionPlanContributions>
        <Total>870437</Total>
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      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>5308209</Total>
        <ProgramServices>3750836</ProgramServices>
        <ManagementAndGeneral>1557373</ManagementAndGeneral>
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      <PayrollTaxes>
        <Total>2405367</Total>
        <ProgramServices>1915065</ProgramServices>
        <ManagementAndGeneral>490302</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>30192</Total>
        <ManagementAndGeneral>30192</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>0</Total>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>11409</Total>
        <ProgramServices>11409</ProgramServices>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>0</Total>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>2728033</Total>
        <ProgramServices>2125773</ProgramServices>
        <ManagementAndGeneral>602260</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>85249</Total>
        <ProgramServices>37340</ProgramServices>
        <ManagementAndGeneral>47909</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>299164</Total>
        <ProgramServices>183437</ProgramServices>
        <ManagementAndGeneral>115727</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>167007</Total>
        <ProgramServices>58959</ProgramServices>
        <ManagementAndGeneral>108048</ManagementAndGeneral>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>1992345</Total>
        <ProgramServices>819300</ProgramServices>
        <ManagementAndGeneral>1173045</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>200565</Total>
        <ProgramServices>150683</ProgramServices>
        <ManagementAndGeneral>49882</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>168676</Total>
        <ProgramServices>119647</ProgramServices>
        <ManagementAndGeneral>49029</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>74077</Total>
        <ProgramServices>41</ProgramServices>
        <ManagementAndGeneral>74036</ManagementAndGeneral>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>3816799</Total>
        <ProgramServices>2101060</ProgramServices>
        <ManagementAndGeneral>1715739</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>260315</Total>
        <ManagementAndGeneral>260315</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>Medical Supplies</Description>
        <Total>5973703</Total>
        <ProgramServices>5982046</ProgramServices>
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      </OtherExpenses>
      <OtherExpenses>
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      </OtherExpenses>
      <OtherExpenses>
        <Description>OTHER DEPARTMENT SUPPLIES</Description>
        <Total>945776</Total>
        <ProgramServices>945776</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Bad Debts</Description>
        <Total>3549959</Total>
        <ProgramServices>3549959</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>MAINTENANCE EQUIPMENT</Description>
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        <ProgramServices>942483</ProgramServices>
      </OtherExpenses>
      <AllOtherExpenses>
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        <ProgramServices>1026154</ProgramServices>
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      </AllOtherExpenses>
      <TotalFunctionalExpenses>
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      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
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      <TotalLiabilities>
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        <EOY>35120295</EOY>
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      <FollowSFAS117>X</FollowSFAS117>
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        <EOY>13403231</EOY>
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      <TemporarilyRestrictedNetAssets>
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      <PermanentlyRestrictedNetAssets>
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        <EOY>100000</EOY>
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      <TotalNetAssetsFundBalances>
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        <EOY>14362452</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
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        <EOY>49482747</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>6513983</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>-9439804</ReconcilationOtherChanges>
      <InfoInScheduleOPartXII>X</InfoInScheduleOPartXII>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
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    <IRS990ScheduleB documentId="IRS990ScheduleB">
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        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
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      <TotalDirectLobbying />
      <TotalLobbyingExpenditures />
      <OtherExemptPurposeExpenditures />
      <TotalExemptPurposeExpenditures />
      <LobbyingNontaxableAmount />
      <GrassrootsNontaxableAmount />
      <TotLobbyingGrassrootMinusNonTx />
      <TotLobbyExpendMnsLobbyingNontx />
      <Volunteers>false</Volunteers>
      <PaidStaffOrManagement>false</PaidStaffOrManagement>
      <MediaAdvertisements>false</MediaAdvertisements>
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      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>false</GrantsOtherOrganizations>
      <DirectContactLegislators>false</DirectContactLegislators>
      <RalliesDemonstrations>false</RalliesDemonstrations>
      <OtherActivities>true</OtherActivities>
      <OtherActivitiesAmount>11409</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>11409</TotalLobbyingExpendituresIIB>
      <Form990ScheduleCPartIV>
        <Identifier>LOBBYING PORTION OF MEMBERSHIP DUES</Identifier>
        <ReturnReference>SCHEDULE C, PART II-B, LINE 1I</ReturnReference>
        <Explanation>Annual dues are paid to the South Dakota Association of Healthcare Organizations and the American Hospital Association. A portion of these dues are applicable to lobbying activities. For fiscal year 2011, dues of $74,144.90 were paid to the South Dakota Association of Healthcare Organizations, 4.68% of which, ($3,470) were used for lobbying purposes; and dues of $32,509.00 were paid to the American Hospital Association, 24.42% of which, ($7,939) were used for lobbying purposes.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
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      <CurrentYearMinus2Years>
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        <BookValue>20909528</BookValue>
      </Buildings>
      <LeaseholdImprovements />
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        <Depreciation>21386774</Depreciation>
        <BookValue>6470647</BookValue>
      </Equipment>
      <OtherLandBuildings>
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        <Depreciation>1321847</Depreciation>
        <BookValue>332915</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>36581169</TotalOfBookValueLandBuildings>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>Due to related parties-investment</Description>
        <Amount>30200028</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>30200028</TotalOfAmounts>
      <Form990ScheduleDPartXIV>
        <Identifier>Endowment Funds</Identifier>
        <ReturnReference>SCHEDULE D, PART V, LINE 4</ReturnReference>
        <Explanation>Endowed funds are held in an interest bearing account. Use of the funds is subject to the terms of the contributor.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>FOOTNOTE TO FINANCIAL STATEMENTS FOR UNCERTAIN TAX POSITIONS UNDER ASC 740</Identifier>
        <ReturnReference>SCHEDULE D, PART X, LINE 2</ReturnReference>
        <Explanation>Regional Health believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. Regional Health would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Regional Health's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2008.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
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        <EntertainmentEvent1>2792</EntertainmentEvent1>
        <OtherDirectExpensesEvent1>55</OtherDirectExpensesEvent1>
        <NameOfEvent2>Golf Tourn.</NameOfEvent2>
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        <GrossRevenueEvent2>23391</GrossRevenueEvent2>
        <RentFacilityCostsEvent2>9272</RentFacilityCostsEvent2>
        <EntertainmentEvent2>1551</EntertainmentEvent2>
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        <GrossReceiptsOtherEvents>19282</GrossReceiptsOtherEvents>
        <GrossRevenueOtherEvents>19282</GrossRevenueOtherEvents>
        <OtherDirectExpensesOtherEvents>4022</OtherDirectExpensesOtherEvents>
        <GrossReceiptsTotal>87084</GrossReceiptsTotal>
        <GrossRevenueTotalEvents>87084</GrossRevenueTotalEvents>
        <RentFacilityCostsTotalEvents>20503</RentFacilityCostsTotalEvents>
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      </EventsInformation>
    </IRS990ScheduleG>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
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      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
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        <PercentOfTotalExpense>0.02970</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
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        <PercentOfTotalExpense>0.14390</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
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          <City>Sturgis</City>
          <State>SD</State>
          <ZIPCode>57785</ZIPCode>
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        <Identifier>SUPPLEMENTAL SCHEDULE H INFORMATION</Identifier>
        <Explanation>REFERENCES TO "REGIONAL HEALTH" APPLY TO ALL ENTITIES CONTROLLED OR LEASED BY REGIONAL HEALTH, INC. THIS INCLUDES THE REPORTING ENTITY.</Explanation>
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      <Form990ScheduleHPartVI>
        <Identifier>PART I, LINE 3C</Identifier>
        <Explanation>Regional Health uses low income housing guideline from Housing and Urban Development for determining financial assistance eligibility. The income guidelines, along with the number of dependents within the household are used in a matrix to determine the percent discount applied to the outstanding balance. Discounts range from 100% to 10% of the balance. The financial assistance policy (i.e. charity policy) also has a catastrophic provision which limits a patient/guarantor's exposure to the lesser of the Financial Assistance reductions or 20% of the family's annual gross income.</Explanation>
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        <Identifier>PART I, LINE 6A</Identifier>
        <Explanation>A community needs assessment is completed by Regional Health, the parent organization, for all related organizations and made available to the public on its website.</Explanation>
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        <Identifier>PART I, LINE 7</Identifier>
        <Explanation>Medicare cost report cost to charge ratio is used for calculation of cost of services provided. The amount of bad debt expense subtracted from the denominator before calculating the percentages in column (f) is $3,549,959.</Explanation>
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        <Identifier>PART II</Identifier>
        <Explanation>Regional Health provides numerous community benefit health events and screenings throughout the Black Hills Region. Regional Health also provides financial support to other nonprofit organizations to help support community health outreach. Additionally, Regional Health provides in-kind support and employee volunteers to help support community health events and activities.</Explanation>
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        <Identifier>PART III, LINE 4</Identifier>
        <Explanation>The allowance for doubtful accounts is based upon management's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category. The results of this review are then used to make any modifications to the allowance for doubtful accounts. After satisfaction of amounts due from insurance and other third-party payors, Regional Health follows established guidelines for placing certain past-due patient balances with collection agencies.</Explanation>
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      <Form990ScheduleHPartVI>
        <Identifier>PART III, LINE 8</Identifier>
        <Explanation>The Medicare shortfall is derived from the actual payments received from the Medicare program for services provided to patients with Medicare coverage. The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost report. The result is a shortfall with costs exceeding the reimbursement.</Explanation>
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        <Explanation>The collection policy requires invoking of the financial assistance policy any time a patient expressed financial difficulty in meeting their debt obligation.</Explanation>
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        <Identifier>NEEDS ASSESSMENT</Identifier>
        <Explanation>Regional Health, worked in partnership with several community not-for-profit organizations to conduct a full Community Needs Assessment (CNA) for the Black Hills region for FY2012. This CNA was the first phase of our data collection and was completed in April 2011. The next phase of the process consisted of meetings, interviews and surveys with people representing the broad interest of the community, including physicians, community health leaders and organizational leadership. In addition to this the organization evaluated quantitative data on health issues for the region from various state, national and internal sources. This phase of our project was completed in September 2011. The organization evaluated all the information gathered in the CNA and through our own research developed our community health targets and is now in the process of developing our implementation plan. More than 30,000 surveys were mailed to the people in the Black Hills Region during the winter of 2010/2011.</Explanation>
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        <Identifier>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</Identifier>
        <Explanation>We provide information on all statements, on our website, we have information available at all admission areas, we contract with Midland Medical Group (an unrelated entity) to meet with all uninsured patients to assist them with finding a funding source or applying for financial assistance, and our self pay outsource partner also communicates any funding and financial assistance opportunities with our patients.</Explanation>
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        <Identifier>COMMUNITY INFORMATION</Identifier>
        <Explanation>Regional Health serves the people of the Black Hills region. The area is mostly rural in nature with only one city of over 50,000 people. Regional Health is the primary medical services provider for the region.</Explanation>
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        <Identifier>OTHER INFORMATION</Identifier>
        <Explanation>Regional Health is governed by a community board that provides leadership to the organization to meet the community needs. Regional Health partners with educational institutions to provide numerous clinical training programs; provides medical services that if were not provided by us would not exist in our Region; and offers health screenings and events to the people of the Region.</Explanation>
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        <Explanation>Regional Health is committed to partnering with communities it serves to meet the needs of each respective community. Regional Health, Inc. is the parent organization of Rapid City Regional Hospital, Inc., Regional Health Network, Inc. and Regional Health Physicians, Inc. These corporations work together to meet the health care needs of the Region.</Explanation>
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        <Identifier>STATE FILING OF COMMUNITY NEEDS ASSESSMENT</Identifier>
        <Explanation>Regional Health community needs assessment is available on its website to all who are interested. All the facilities owned or controlled by Regional Health are located in South Dakota.</Explanation>
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        <Identifier>SUPPLEMENTAL COMPENSATION INFORMATION</Identifier>
        <ReturnReference>PART I, LINE 3</ReturnReference>
        <Explanation>The Audit and Compliance Committee, which is a committee of the Regional Health (Parent) Board, reviews and approves base salary and total compensation ranges for all executives with the Regional Health System. Please see Form 990, Part VI, Line 15b disclosure on Schedule O.</Explanation>
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      <Form990ScheduleJPartIII>
        <Identifier>SUPPLEMENTAL COMPENSATION INFORMATION</Identifier>
        <ReturnReference>Schedule J, Part I, Line 4b</ReturnReference>
        <Explanation>Regional Health provides a supplemental nonqualified retirement plan and a flexible benefit plan that can include deferred compensation for its executives. See column 'C' on schedule J for those persons listed in form 990, Part VII, line 1a that participated in or received payment from these two plans.</Explanation>
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    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>OTHER PROGRAM SERVICES</Identifier>
        <ReturnReference>FORM 990, PART III, LINE 4D</ReturnReference>
        <Explanation>THE REGIONAL HEALTH NETWORK, INC. IS A NETWORK OF SMALL HOSPITALS, NURSING HOMES AND ASSISTED LIVING FACILITIES IN WESTERN SOUTH DAKOTA. THESE HOSPITALS AND LONG TERM CARE FACILITIES ARE LOCATED IN SMALL RURAL TOWNS AND PROVIDE A VERY NECESSARY RURAL HEALTHCARE SAFETY NET. PART IV, LINE 24E BOND ISSUES ALL RELATED CORPORATIONS ARE EQUALLY LIABLE FOR THE REPAYMENT OF THE BONDS REPORTED ON THE RAPID CITY REGIONAL HOSPITAL FORM 990.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS</Identifier>
        <ReturnReference>Form 990, Part VI, Question 6, 7a and 7b</ReturnReference>
        <Explanation>REGIONAL HEALTH, INC. IS THE SOLE MEMBER OF REGIONAL HEALTH NETWORK, INC. REGIONAL HEALTH, INC. HAS AUTHORITY OVER CERTAIN DECISIONS PERTAINING TO REGIONAL HEALTH NETWORK, INC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIBE THE PROCESS USED BY MANAGEMENT &amp;/OR GOVERNING BODY TO REVIEW 990</Identifier>
        <ReturnReference>FORM 990, PART VI QUESTION 11B</ReturnReference>
        <Explanation>THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. IT IS THEN REVIEWED INTERNALLY BY FINANCE AND LEGAL MANAGEMENT. THE FORM 990 IS FURTHER REVIEWED, PRIOR TO FILING, BY THE ORGANIZATION'S BOARD OF DIRECTORS THROUGH A PORTAL TO THE ORGANIZATION'S INTERNAL INFORMATION SYSTEM, TO WHICH EACH BOARD MEMBER HAS ACCESS. EDUCATIONAL SESSIONS HAVE BEEN PROVIDED TO EACH BOARD MEMBER ON HOW TO ACCESS THE PORTAL.</Explanation>
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      <GeneralExplanation>
        <Identifier>Description of Process to Monitor Transactions for Conflicts of Interest</Identifier>
        <ReturnReference>Form 990, Part VI, Question 12c</ReturnReference>
        <Explanation>AS A PART OF THE ANNUAL DISCLOSURE OF POTENTIAL CONFLICTS PROCESS, ALL BOARD MEMBERS, OFFICERS, AND OTHER MANAGEMENT PERSONNEL RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY AND SIGN AN ACKNOWLEDGEMENT THAT THEY HAVE READ AND UNDERSTAND IT. ADDITIONALLY, THEY ARE EACH REQUIRED TO COMPLETE A DISCLOSURE STATEMENT. ANNUALLY, A SUMMARY LIST OF ALL CONFLICTS DISCLOSED BY BOARD MEMBERS IS PREPARED AND PROVIDED TO THE FULL BOARD SO BOARD MEMBERS ARE AWARE OF THE CONFLICTS / INTERESTS OF OTHER BOARD MEMBERS AND ARE ABLE TO POINT OUT CONFLICTS IF AN INDIVIDUAL MEMBER WITH A CONFLICT FORGETS. ADDITIONALLY, THE AGENDA FOR EACH BOARD MEETING AND EACH BOARD COMMITTEE MEETING INCLUDES AN INITIAL AGENDA ITEM "CONFLICTS OF INTEREST" WHERE BOARD MEMBERS ARE ASKED IF THEY HAVE ANY CONFLICTS RELATED TO THE OTHER ITEMS ON THE AGENDA. ALL EMPLOYEES ARE COVERED BY THE CONFLICT OF INTEREST POLICY BUT COMPLETION OF THE ANNUAL DISCLOSURE STATEMENT IS LIMITED TO BOARD AND BOARD COMMITTEE MEMBERS, MANAGEMENT, CERTAIN PHYSICIANS, AND CERTAIN NON-MANAGEMENT EMPLOYEES INVOLVED IN PURCHASING. WHERE A PROPOSED TRANSACTION INVOLVES A BOARD MEMBER, THE TRANSACTION IS REVIEWED BY THE COMPLIANCE AND AUDIT COMMITTEE OF THE SOLE MEMBER. BOARD MEMBERS WHO HAVE A CONFLICT OF INTEREST MAY BE INVITED TO SPEAK ON THE MATTER BY THE CHAIRMAN, BUT ARE NOT PERMITTED TO VOTE ON THE MATTER AND ARE REQUIRED TO LEAVE THE MEETING DURING DISCUSSION, AFTER THEY HAVE MADE ANY COMMENTS INVITED BY THE CHAIR.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Offices &amp; Positions for Which Process was Used, &amp; Year Process was Begun</Identifier>
        <ReturnReference>Form 990, Part VI, Question 15A &amp; 15b</ReturnReference>
        <Explanation>THE COMPLIANCE AND AUDIT COMMITTEE OF THE SOLE MEMBER'S BOARD, A COMMITTEE THAT INCLUDES ONLY BOARD MEMBERS DEEMED "INDEPENDENT", DETERMINES THE APPROPRIATE BASE SALARY RANGE OF THE CEO OF THE ORGANIZATION AND ITS OTHER EXECUTIVE STAFF. THE CEO OF THE MEMBER OR HIS DESIGNEE THEN DETERMINES THE ACTUAL BASE SALARY OF THE OTHER EXECUTIVES WITHIN THE COMMITTEE-APPROVED RANGES BASED ON A PERFORMANCE EVALUATION CONDUCTED BY THE CEO OR DESIGNEE. FOR DETERMINATION OF THE BASE SALARY RANGES, AS WELL AS INCENTIVE COMPENSATION, BENEFIT PLANS AND PERQUISITES (TOTAL COMPENSATION), THE COMPLIANCE AND AUDIT COMMITTEE RETAINS AN INDEPENDENT CONSULTANT, SULLIVAN AND COTTER, TO PROVIDE SURVEY / COMPARABILITY DATA FOR BOTH BASE SALARY AND TOTAL COMPENSATION AT LEAST EVERY THREE YEARS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, &amp; FIN STMTS TO GEN PUBLIC</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 19</ReturnReference>
        <Explanation>THE ARTICLES OF INCORPORATION OF THE ORGANIZATION ARE FILED IN THE OFFICE OF THE SECRETARY OF STATE OF SOUTH DAKOTA AND ARE AVAILABLE TO THE PUBLIC. OTHER DOCUMENTS (BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS) ARE NOT POSTED FOR THE PUBLIC BUT ARE AVAILABLE OR DESCRIBED IN OTHER PUBLIC DOCUMENTS SUCH AS OFFERING STATEMENTS IN BOND ISSUES OR MUNICIPAL SECURITIES RULEMAKING BOARD'S ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) DATA PORT.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION OF OFFICERS DIRECTORS TRUSTEES</Identifier>
        <ReturnReference>FORM 990, PART VII</ReturnReference>
        <Explanation>THE HOURS DEVOTED TO THE POSITIONS REPORTED ON THE ATTACHMENT TO PART VII AND SCHEDULE J FOR THE FOLLOWING REFLECT THE AGGREGATE TOTAL HOURS THESE INDIVIDUALS DEVOTE TO THEIR POSITIONS FOR RAPID CITY REGIONAL HOSPITAL, INC., REGIONAL HEALTH, INC., REGIONAL HEALTH PHYSICIANS, INC. AND/OR REGIONAL HEALTH NETWORK, INC. CHARLES E. HART, MD LAVERN BILLS PETER CAPPA JON DAHLSTROM DOYLE ESTES WARREN GOLLIHER, MD TERRY GRABER, MD THOMAS GROEGER, MD JORGE JOHNSON, MD ROSS LAMPHERE JUDITH LARSON KEN SABERS TIMOTHY SUGHRUE JOSEPH SLUKA MARK THOMPSON INDEPENDENT BOARD MEMBERS FORM 990, PART VII REGIONAL HEALTH CONSIDERS SOME MEMBERS OF THE BOARD TO NOT BE INDEPENDENT BECAUSE THEY ARE ACTIVELY PRACTICING PHYSICIANS ON ONE OF ITS HOSPITALS' MEDICAL STAFFS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5</ReturnReference>
        <Explanation>CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRI $(9,383,860) OTHER CHANGES IN UNRESTRICTED NET ASSETS $ (55,944) ------------ LINE 5 TOTAL $(9,439,804)</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OVERSIGHT OR SELECTION PROCESS</Identifier>
        <ReturnReference>FORM 990, PART XII, QUESTION 2C</ReturnReference>
        <Explanation>INDEPENDENT AUDITORS ARE ENGAGED BY THE COMPLIANCE AND AUDIT COMMITTEE OF THE REGIONAL HEALTH, INC BOARD OF TRUSTEES. FINAL AUDIT RESULTS, ON A CONSOLIDATED BASIS, ARE REPORTED BY THE INDEPENDENT AUDITORS DIRECTLY TO THE COMPLIANCE AND AUDIT COMMITTEE.</Explanation>
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          <State>SD</State>
          <ZIPCode>57108</ZIPCode>
        </AddressUS>
        <PrimaryActivity>COLLAB PURCH NEG.</PrimaryActivity>
        <LegalDomicileState>SD</LegalDomicileState>
        <PredominantIncomeType>n/a</PredominantIncomeType>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Western Providers Inc</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>677 Cathedral Dr Ste 309</AddressLine1>
          <City>Rapid City</City>
          <State>SD</State>
          <ZIPCode>57701</ZIPCode>
        </AddressUS>
        <EIN>411889163</EIN>
        <PrimaryActivity>Medical Service</PrimaryActivity>
        <LegalDomicileState>SD</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C Corp</TypeOfEntity>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Regional Health Physicians Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>i</TransactionType>
        <AmountInvolved>443439</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Rapid City Regional Hospital Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>n</TransactionType>
        <AmountInvolved>42005165</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Rapid City Regional Hospital Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
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      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Rapid City Regional Hospital Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>l</TransactionType>
        <AmountInvolved>6514712</AmountInvolved>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>