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      <NumberOfContractorsGT100K>14</NumberOfContractorsGT100K>
      <FundraisingEvents>17345</FundraisingEvents>
      <GovernmentGrants>30259</GovernmentGrants>
      <AllOtherContributions>11546</AllOtherContributions>
      <TotalContributions>59150</TotalContributions>
      <ProgramServiceRevenue>
        <Description>INPATIENT REVENUE</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>20181599</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>20181599</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>OUTPATIENT REVENUE</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>13717222</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>13717222</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>PHYSICIAN OFFICE REVENUE</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>8101299</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>8101299</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalProgramServiceRevenue>42000120</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>40842</TotalRevenueColumn>
        <ExclusionAmount>40842</ExclusionAmount>
      </InvestmentIncome>
      <IncomeFromInvestBondProceeds>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </IncomeFromInvestBondProceeds>
      <RoyaltiesRevenue>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </RoyaltiesRevenue>
      <GrossRents>
        <Real>326022</Real>
      </GrossRents>
      <RentalIncomeOrLoss>
        <Real>326022</Real>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>326022</TotalRevenueColumn>
        <ExclusionAmount>326022</ExclusionAmount>
      </NetRentalIncomeOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetGainOrLossInvestments>
      <GrossIncomeFundraisingEvents>17767</GrossIncomeFundraisingEvents>
      <CntrbtnsRprtdFundraisingEvents>17345</CntrbtnsRprtdFundraisingEvents>
      <FundraisingDirectExpenses>5248</FundraisingDirectExpenses>
      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>12519</TotalRevenueColumn>
        <ExclusionAmount>12519</ExclusionAmount>
      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromGaming>
      <NetIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeOrLoss>
      <OtherRevenueMisc>
        <Description>CAFETERIA</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>85633</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>85633</RelatedOrExemptFunctionIncome>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>OTHER OPERATING REVENUE</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>69559</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>69559</RelatedOrExemptFunctionIncome>
      </OtherRevenueMisc>
      <TotalOtherRevenue>155192</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>42593845</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>42155312</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>379383</ExclusionAmount>
      </TotalRevenue>
      <GrantsToDomesticOrgs>
        <Total>0</Total>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>2410985</Total>
        <ProgramServices>1928788</ProgramServices>
        <ManagementAndGeneral>482197</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>12572976</Total>
        <ProgramServices>10058381</ProgramServices>
        <ManagementAndGeneral>2514595</ManagementAndGeneral>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>941570</Total>
        <ProgramServices>753256</ProgramServices>
        <ManagementAndGeneral>188314</ManagementAndGeneral>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>5305214</Total>
        <ProgramServices>4244171</ProgramServices>
        <ManagementAndGeneral>1061043</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>1172333</Total>
        <ProgramServices>937866</ProgramServices>
        <ManagementAndGeneral>234467</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>595387</Total>
        <ProgramServices>476310</ProgramServices>
        <ManagementAndGeneral>119077</ManagementAndGeneral>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>122363</Total>
        <ProgramServices>97890</ProgramServices>
        <ManagementAndGeneral>24473</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>54996</Total>
        <ProgramServices>43997</ProgramServices>
        <ManagementAndGeneral>10999</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>0</Total>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>4388551</Total>
        <ProgramServices>3510841</ProgramServices>
        <ManagementAndGeneral>877710</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>162750</Total>
        <ProgramServices>130200</ProgramServices>
        <ManagementAndGeneral>32550</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>6612459</Total>
        <ProgramServices>5289967</ProgramServices>
        <ManagementAndGeneral>1322492</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>107034</Total>
        <ProgramServices>85627</ProgramServices>
        <ManagementAndGeneral>21407</ManagementAndGeneral>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>821216</Total>
        <ProgramServices>656973</ProgramServices>
        <ManagementAndGeneral>164243</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>108281</Total>
        <ProgramServices>86625</ProgramServices>
        <ManagementAndGeneral>21656</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>69390</Total>
        <ProgramServices>55512</ProgramServices>
        <ManagementAndGeneral>13878</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>627881</Total>
        <ProgramServices>502305</ProgramServices>
        <ManagementAndGeneral>125576</ManagementAndGeneral>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>1474646</Total>
        <ProgramServices>1179717</ProgramServices>
        <ManagementAndGeneral>294929</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>769970</Total>
        <ProgramServices>615976</ProgramServices>
        <ManagementAndGeneral>153994</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>BAD DEBTS</Description>
        <Total>2648098</Total>
        <ProgramServices>2648098</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>RENTAL AND LEASES</Description>
        <Total>1349524</Total>
        <ProgramServices>1079619</ProgramServices>
        <ManagementAndGeneral>269905</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>OTHER PURCHASED SERVICES</Description>
        <Total>1442417</Total>
        <ProgramServices>1153934</ProgramServices>
        <ManagementAndGeneral>288483</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>OTHER</Description>
        <Total>86868</Total>
        <ProgramServices>69494</ProgramServices>
        <ManagementAndGeneral>17374</ManagementAndGeneral>
      </OtherExpenses>
      <TotalFunctionalExpenses>
        <Total>43844909</Total>
        <ProgramServices>35605547</ProgramServices>
        <ManagementAndGeneral>8239362</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>650</BOY>
        <EOY>650</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>2316810</BOY>
        <EOY>1495337</EOY>
      </SavingsAndTempCashInvestments>
      <AccountsReceivable>
        <BOY>5990820</BOY>
        <EOY>6341273</EOY>
      </AccountsReceivable>
      <InventoriesForSaleOrUse>
        <BOY>835238</BOY>
        <EOY>767427</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>460932</BOY>
        <EOY>361368</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>46461863</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>26381827</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>21018393</BOY>
        <EOY>20080036</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsOtherSecurities>
        <BOY>0</BOY>
        <EOY>255265</EOY>
      </InvestmentsOtherSecurities>
      <InvestmentsProgramRelated>
        <BOY>1275253</BOY>
        <EOY>1397544</EOY>
      </InvestmentsProgramRelated>
      <OtherAssetsTotal>
        <BOY>2945463</BOY>
        <EOY>3455982</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>34843559</BOY>
        <EOY>34154882</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>1833067</BOY>
        <EOY>1828160</EOY>
      </AccountsPayableAccruedExpenses>
      <TaxExemptBondLiabilities>
        <BOY>10375000</BOY>
        <EOY>12236742</EOY>
      </TaxExemptBondLiabilities>
      <OtherLiabilities>
        <BOY>6180016</BOY>
        <EOY>3960958</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>18388083</BOY>
        <EOY>18025860</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>9227903</BOY>
        <EOY>16085549</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>8132</BOY>
        <EOY>43473</EOY>
      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
        <BOY>7219441</BOY>
        <EOY>0</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>16455476</BOY>
        <EOY>16129022</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>34843559</BOY>
        <EOY>34154882</EOY>
      </TotalLiabNetAssetsFundBalances>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementSeparate>X</FinancialStatementSeparate>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <Land>
        <OtherCostOrOtherBasis>109943</OtherCostOrOtherBasis>
        <BookValue>109943</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>27676099</OtherCostOrOtherBasis>
        <Depreciation>10395002</Depreciation>
        <BookValue>17281097</BookValue>
      </Buildings>
      <LeaseholdImprovements>
        <OtherCostOrOtherBasis>4497</OtherCostOrOtherBasis>
        <Depreciation>4497</Depreciation>
        <BookValue>0</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <OtherCostOrOtherBasis>18063800</OtherCostOrOtherBasis>
        <Depreciation>15713117</Depreciation>
        <BookValue>2350683</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>607522</OtherCostOrOtherBasis>
        <Depreciation>269209</Depreciation>
        <BookValue>338313</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>20080036</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>EST. DUE FROM THIRD PARTY</Description>
        <BookValue>1205852</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>DEFERRED FINANCING COSTS</Description>
        <BookValue>302051</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>PENSION ASSET</Description>
        <BookValue>219087</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>OTHER</Description>
        <BookValue>1250</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>BOARD DESIGNATED SAVINGS</Description>
        <BookValue>1727742</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>3455982</TotalBookValueOtherAssets>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>CURRENT PORTION OF LTD</Description>
        <Amount>339072</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ACCRUED EXPENSES AND OTHER LIABILITIES</Description>
        <Amount>2850368</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>LONG-TERM DEBT</Description>
        <Amount>771518</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>3960958</TotalOfAmounts>
      <TotalRevenue>42593845</TotalRevenue>
      <TotalExpenses>43844909</TotalExpenses>
      <ExcessOrDeficitForYear>-1251064</ExcessOrDeficitForYear>
      <OtherAmount>1037691</OtherAmount>
      <TotalAdjustments>1037691</TotalAdjustments>
      <ExcessOrDeficitPerFS>-213373</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>44505855</TotRevenueEtcAuditedFinclStmt>
      <OtherRevenues>1912010</OtherRevenues>
      <RevenueNotRptdF990>1912010</RevenueNotRptdF990>
      <RevenueSubtotal>42593845</RevenueSubtotal>
      <TotalRevenuePerForm990>42593845</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>45584228</TotExpensesEtcAuditedFinclStmt>
      <OtherExpensesIncluded>1739319</OtherExpensesIncluded>
      <ExpensesNotRptdF990>1739319</ExpensesNotRptdF990>
      <ExpensesSubtotal>43844909</ExpensesSubtotal>
      <TotalExpensesPerForm990>43844909</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIV>
        <Identifier>RECONCILIATION</Identifier>
        <ReturnReference>PART XI, XII, &amp; XIII</ReturnReference>
        <Explanation>PART XI, LINE 8: CHANGE IN DEFINED PENSION PLAN LOSSES (1,739,319) GAIN ON TRANSFER OF PENSION ASSET + 1,912,010 CUMULATIVE EFFECT OF ADOPTION OF FAIR VALUE OPTION + 865,000 TOTAL 1,037,691 PART XII, LINE 2D: GAIN ON TRANSFER OF PENSION ASSET 1,912,010 PART XIII, LINE 2D: CHANGE IN DEFINED PENSION PLAN LOSSES 1,739,319</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>FIN 48 FOOTNOTE</Identifier>
        <Explanation>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.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="IRS990ScheduleG">
      <EventsInformation>
        <NameOfEvent1>MURDER MYSTERY</NameOfEvent1>
        <GrossReceiptsEvent1>35112</GrossReceiptsEvent1>
        <CharitableContributionsEvent1>17345</CharitableContributionsEvent1>
        <GrossRevenueEvent1>17767</GrossRevenueEvent1>
        <RentFacilityCostsEvent1>4766</RentFacilityCostsEvent1>
        <OtherDirectExpensesEvent1>483</OtherDirectExpensesEvent1>
        <TotalNumberOfOtherEvents>0</TotalNumberOfOtherEvents>
        <GrossReceiptsTotal>35112</GrossReceiptsTotal>
        <CharitableContributionsTotal>17345</CharitableContributionsTotal>
        <GrossRevenueTotalEvents>17767</GrossRevenueTotalEvents>
        <RentFacilityCostsTotalEvents>4766</RentFacilityCostsTotalEvents>
        <OtherDirectExpensesTotalEvents>483</OtherDirectExpensesTotalEvents>
        <DirectExpenseSummaryEvents>5249</DirectExpenseSummaryEvents>
        <NetIncomeSummary>12518</NetIncomeSummary>
      </EventsInformation>
    </IRS990ScheduleG>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent200D>X</Pcent200D>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>1508820</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>337386</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1171434</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03570</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>7015670</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>7866502</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>-850832</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02600</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>8524490</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>8203888</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>320602</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00970</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>64468</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1715</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>62753</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00140</PercentOfTotalExpense>
      </CommunityHealthServices>
      <Research>
        <TotalCommunityBenefitExpense>85943</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>85943</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00260</PercentOfTotalExpense>
      </Research>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>14081</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>14081</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00040</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>164492</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1715</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>162777</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00440</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>8688982</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>8205603</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>483379</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01410</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>1019223</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>7490499</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>24685162</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-17194663</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>QUORUM HEALTH RSRCS</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>MANAGEMENT OF OPERATIONS</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.00000</OrganizationProfitOrOwnership>
        <OfficersEtcProfitOrOwnership>0.00000</OfficersEtcProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.00000</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>STURGIS HOSPITAL</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>916 MYRTLE AVENUE</AddressLine1>
          <City>STURGIS</City>
          <State>MI</State>
          <ZIPCode>49091</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartVI>
        <IncomeBasedCriteria>Sturgis Hospital Acknowledges that all individuals are not equally capable of withstanding the burden of payment for healthcare services. The Hospital provides and promotes access to emergency and medically necessary services without regard to ability to pay. According to the Hospital's existing public policy, all patients receiving medically necessary services are eligible for financial assistance. Eligibility criteria is based on the need of the patients, lack of existing insurance, and other resources required for payment. Eligibility criteria is further based on the Federal Poverty Guidelines at a level of 200% of that guideline.</IncomeBasedCriteria>
        <AnnualCommunityBenefitExpln>STURGIS HOSPITAL PUBLISHES ITS ANNUAL REPORT WHICH INCLUDES ALL RELATED ORGANIZATIONS' PROGRAMS AND SERVICES DESIGNED TO LEAD THE COMMUNITY TO IMPROVED HEALTH AND PROMOTE HEALTHY LIFESTYLES. THE REPORT IS AVAILABLE ON STURGIS'S WEBSITE.</AnnualCommunityBenefitExpln>
        <CostingMethodUsed>NOT APPLICABLE</CostingMethodUsed>
        <SubsidizedHealthServicesExpln>Subsidized health services included within the Hospital is the obstetrics services. Costs associated with the Women's Center physician clinics is $592,133.</SubsidizedHealthServicesExpln>
        <PercentOfTotalExpenseExpln>BAD DEBT EXPENSE IN THE AMOUNT OF $2,648,098 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. THE ORGANIZATION USES A COMBINATION OF THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H AND DIRECT COSTING METHOD OF CERTAIN PROGRAMS.</PercentOfTotalExpenseExpln>
        <BadDebtFootnote>The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Hospital provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Hospital bills third-party payers directly and bills the patient when the patients liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Charges are reported at 100%, and the amount written off to bad DEBT is reduced to cost by applying the cost to charge ratio.</BadDebtFootnote>
        <ShortfallAsCommunityBenefit>Costing Methodology to determine the Medicare allowable costs reported in the MCR is a statistical step down allocation method. Any shortfall should be treated as a community benefit since the hospital provides these services as a community benefit despite the fact that they are provided at a financial loss.</ShortfallAsCommunityBenefit>
        <DebtCollectionPolicy>Once a the evaluation is completed and a determination has been made that patients qualify for financial assistance, no collection efforts are made. Consideration for assistance is also given to other types of patients if felt need for assistance is required.</DebtCollectionPolicy>
        <NeedsAssessment>The organization assesses the health care needs of the community through community surveys, as well as monitoring benchmarks during the hospital's planning processes of supply and demand of physician specialty and service demands within the community.</NeedsAssessment>
        <PatientEducationAssistance>The organization informs and educates patients and persons who may be billed for patient care about their eligibility and availability of financial assistance by: Posting the organizations charity care policy in access and registration areas within the Hospital Individual interview of patients by financial counselors and preadmission staff with discussions concerning financial assistance, availability of various government benefits and assistance with the application for assistance. The Hospital has entered a memorandum of understanding with the County whereas the Hospital makes a commitment to provide3 health care services to low income residents of the County (public record) The Hospital does not include a copy of the policy as part of the intake or discharge process, nor is it included in the patient bill</PatientEducationAssistance>
        <CommunityInformation>As of 2010, Sturgis Metro Area's population is 62,490 people. Since 2000, it has had a population growth of 0.08 percent. The median home cost in Sturgis Metro Area is $96,330. Home appreciation the last year has been -5.92 percent. Compared to the rest of the country, Sturgis Metro Area's cost of living is 17.90% Lower than the U.S. average. Sturgis Metro Area public schools spend $4,838 per student. The average school expenditure in the U.S. is $5,678. There are about 16.7 students per teacher in Sturgis Metro Area. The unemployment rate in Sturgis Metro Area is 13.40 percent(U.S. avg. is 10.20%). Recent job growth is Negative. Sturgis Metro Area jobs have Decreased by 7.17 percent.</CommunityInformation>
        <OtherInformation>The Hospital further it exempt purpose and mission as demonstrated by: A majority of the Organizations governing body is compromised by persons who reside in the organizations primary service area, who are neither employees nor contractors of the organization, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in its community (open medical staff). All surplus funds are reinvested into the organization to promote service enhancement to its community as well as capital replacement and service development. The Organization further promotes its mission by participation in health care screening, health care education and certain services made to the community at no cost to the community. Organization has entered into memorandum of understanding with St. Joseph County committing to provide services to the community regardless of the ability to pay for those services. Community Benefit report would be filed only in the State of Michigan.</OtherInformation>
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        <DescriptionOfPurpose>HOSPITAL EXPANSION PROJECT</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
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        </IssuerName>
        <IssuerEIN>386004653</IssuerEIN>
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        <IssuePrice>2334795</IssuePrice>
        <DescriptionOfPurpose>HOSPITAL EXPANSION PROJECT</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
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        <YearOfSubstCompletion>2012</YearOfSubstCompletion>
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      <GeneralExplanation>
        <Identifier>GOVERNING BODY &amp; MANAGEMENT</Identifier>
        <ReturnReference>PART VI, SECTION A</ReturnReference>
        <Explanation>QUESTION 3: Board of Trustees has engaged Quorum Health Resources to provide management services under the strict policies and bylaws adopted by the Board of Trustees.</Explanation>
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      <GeneralExplanation>
        <Identifier>POLICIES</Identifier>
        <ReturnReference>PART VI, SECTION B</ReturnReference>
        <Explanation>QUESTION 11: THE FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS. QUESTION 12: BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. DISCLOSURES ARE REVIEWED TO DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT EXISTS, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS RELATING TO THE CONFLICT. QUESTION 15: COMPENSATION LEVELS ARE DETERMINED AT THE BOARD LEVEL UTILIZING VARIOUS SALARY SURVEYS FROM STATE HOSPITAL ASSOCIATION AS WELL AS THE MANAGEMENT COMPANY'S DATA BASE OF SALARY SCALES AND PROFESSIONAL RECRUITMENT FIRMS. QUESTION 19: STURGIS HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.</Explanation>
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