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        <CurrentTaxYearMinus3YearsAmt>84159652</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>111200</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>92200</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>93006547</TotalAmt>
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      <SubstantialContributorsTotAmt>79174309</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>13832238</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
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        <CurrentTaxYearMinus3YearsAmt>256772</CurrentTaxYearMinus3YearsAmt>
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        <CurrentTaxYearMinus1YearAmt>747980</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>226434</CurrentTaxYearAmt>
        <TotalAmt>1858915</TotalAmt>
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      <UnrelatedBusinessNetIncm170Grp>
        <TotalAmt>0</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
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        <CurrentTaxYearMinus1YearAmt>4048824</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>114468</CurrentTaxYearAmt>
        <TotalAmt>4223696</TotalAmt>
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      <TotalSupportAmt>99089158</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>565100021</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.13959</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.1398</PublicSupportPY170Pct>
      <TenPctFactsCrcmstncsTestCYInd>X</TenPctFactsCrcmstncsTestCYInd>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part II, Line 17a FACTS AND CIRCUMSTANCES TEST</FormAndLineReferenceDesc>
        <ExplanationTxt>PENN HIGHLANDS HEALTHCARE (THE GANIZATION', 'PHH') QUALIFIES AS A PUBLICLY SUPPORTED CHARITY BY SATISFYING THE 10 PERCENT AND FACTS AND CIRCUMSTANCES TEST UNDER TREAS. REG. 1.170A-9(F)(3) IN THE FOLLOWING RESPECTS: 10 PERCENT OF SUPPORT LIMITATION: PHH CONSISTENTLY RECEIVES A SUBSTANTIAL PORTION OF ITS SUPPORT FROM THE PUBLIC AND A VARIETY OF UNRELATED DONORS. PHH'S PUBLIC SUPPORT PERCENTAGE WAS 13.96 AND 13.98 PERCENT IN 2024 AND 2023, RESPECTIVELY, ABOVE THE 10 PERCENT THRESHOLD REQUIRED BY THE REGULATIONS. THIS DEMONSTRATES A MEANINGFUL LEVEL OF SUPPORT FROM THE PUBLIC AND UNRELATED DONORS. BROAD BASE OF PUBLIC SUPPORT: IN ADDITION TO SIGNIFICANT SUPPORT FROM AFFILIATED HOSPITALS, PHH RECEIVES CONTRIBUTIONS FROM A BROAD BASE OF INDIVIDUALS AND ORGANIZATIONS. FUNDRAISING ACTIVITIES ATTRACT PUBLIC SUPPORT FROM A VARIETY OF DONORS THROUGHOUT THE REGION. PHH'S SUPPORT IS NOT DERIVED FROM A SINGLE FAMILY OR A SMALL GROUP OF RELATED DONORS. THE ORGANIZATION IS ORGANIZED AND OPERATED TO ATTRACT NEW AND ADDITIONAL PUBLIC SUPPORT ON A CONTINUOUS BASIS, MAINTAINING AN ACTIVE AND BONA FIDE FUNDRAISING PROGRAM, INCLUDING ONGOING ENGAGEMENT WITH DONORS THROUGH EVENTS AND COMMUNICATIONS. PHH'S STAFF AND BOARD OF DIRECTORS ARE COMMITTED TO SEEKING SUPPORT FROM INDIVIDUALS, FOUNDATIONS, AND OTHER CHARITABLE ORGANIZATIONS, AND REGULARLY WORK TO IDENTIFY AND CULTIVATE NEW PROSPECTIVE DONORS. PHH'S MISSION - TO IMPROVE REGIONAL ACCESS TO A WIDE ARRAY OF HEALTH SERVICES - HAS BROAD APPEAL TO THE GENERAL PUBLIC, PATIENTS, FAMILIES, AND THE WIDER COMMUNITY. REPRESENTATIVE GOVERNING BODY: PHH'S BOARD OF DIRECTORS CONSISTS OF 22 INDIVIDUALS, ONLY FIVE OF WHOM ARE REPRESENTATIVES OF THE ORGANIZATION. THE REMAINDER OF THE BOARD IS COMPRISED OF INDIVIDUALS FROM THE BROADER COMMUNITY, REPRESENTING A RANGE OF PERSPECTIVES AND DISCIPLINE IN THE HEALTH CARE FIELD, COMMUNITY LEADERS, AND REGIONAL DEVELOPMENT. THIS STRUCTURE ENSURES THAT PHH'S GOVERNANCE REFLECTS THE INTERESTS OF THE PUBLIC AND THE COMMUNITIES IT SERVES. CONTINUOUS PROVISION OF PUBLIC BENEFIT: PHH DIRECTLY PROVIDES SERVICES THAT BENEFIT THE GENERAL PUBLIC ON A CONTINUING BASIS AND ACCOMPLISH CHARITABLE WORK IN ITS COMMUNITY BY OPERATING AS THE PARENT ORGANIZATION OF A HEALTH SYSTEM, CONTROLLING AND PROVIDING MANAGEMENT AND OTHER SHARED SERVICES TO SEVERAL AFFILIATED HOSPITALS. PHH'S ACTIVITIES ARE DESIGNED TO IMPROVE REGIONAL ACCESS TO HEALTH SERVICES AND PROVIDE ONGOING BENEFITS TO THE PUBLIC. THROUGH ITS MANAGEMENT OF AFFILIATED HOSPITALS AND COORDINATION OF SHARED SERVICES, PHH ENSURES THE DELIVERY OF HIGH-QUALITY HEALTH CARE TO DIVERSE POPULATIONS. PHH'S PROGRAMS AND INITIATIVES ARE DESIGNED TO ENGAGE AND SERVE THE PUBLIC, FULFILLING ITS CHARITABLE MISSION AS SET FORTH IN ITS ARTICLES OF INCORPORATION.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part II, Line 10 Other Income</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION - OTHER INCOME, COLUMN A - 27852.0, COLUMN B - , COLUMN C - 32552.0, COLUMN D - 4048824.0, COLUMN E - 114468.0, COLUMN F - 4223696.0;</ExplanationTxt>
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        <BookValueAmt>5951913</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>5951913</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>DUE FROM AFFILIATES</Desc>
        <BookValueAmt>405530028</BookValueAmt>
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      <OtherAssetsOrgGrp>
        <Desc>INSURANCE REC</Desc>
        <BookValueAmt>17822903</BookValueAmt>
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      <OtherAssetsOrgGrp>
        <Desc>PENSION ASSET</Desc>
        <BookValueAmt>5174351</BookValueAmt>
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      <OtherAssetsOrgGrp>
        <Desc>OTHER ASSETS</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Federal Income Taxes</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATES</Desc>
        <Amt>263700337</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>CERNER PAYMENT PLAN</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER LIABILITIES</Desc>
        <Amt>449522</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>EMPLOYEE ADVANCES</Desc>
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        <ExplanationTxt>UNCERTAIN TAX POSITIONS: PENN HIGHLANDS HEALTHCARE INC. IS INCLUDED IN PENN HIGHLANDS HEALTHCARE'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE FOLLOWING NARRATIVE IS THE FOOTNOTE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS: THE SYSTEM AND ITS SUBSIDIARIES HAVE GENERALLY BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THESE ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE SYSTEM CONSOLIDATES CERTAIN ENTITIES, WHICH ARE ORGANIZED AS CORPORATIONS AND SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. OTHER CONSOLIDATED AFFILIATES HAVE ELECTED TO BE TAXED AS A PARTNERSHIP UNDER PROVISIONS OF THE INTERNAL REVENUE CODE AND A SIMILAR SECTION OF THE STATE INCOME TAX LAW. THEREFORE, TAXABLE INCOME OR LOSS IS REPORTED TO THE INDIVIDUAL MEMBERS FOR INCLUSION IN THEIR RESPECTIVE TAX RETURNS. TO THE EXTENT THAT THE OPERATIONS OF THE PARTNERSHIP ENTITIES ARE RELATED TO THE SYSTEM'S TAX-EXEMPT PURPOSE, ITS INCOME WILL BE EXEMPT FROM INCOME TAXES. THE SYSTEM AND ITS SUBSIDIARIES ACCOUNT FOR UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN, OR EXPECTED TO BE TAKEN, IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN, AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THE SYSTEM'S FOR-PROFIT CORPORATIONS RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR THE FUTURE TAX IMPACT OF TEMPORARY DIFFERENCES BETWEEN AMOUNTS RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS AND THEIR RESPECTIVE TAX BASES, AND THE FUTURE BENEFIT OF UTILIZING AVAILABLE NET OPERATING LOSSES. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. INCOME TAXES OF THE SYSTEM'S TAX-EXEMPT, FOR-PROFIT AND PARTNERSHIP ENTITIES ARE RECORDED IN ACCRUED EXPENSES ON THE CONSOLIDATED BALANCE SHEET.</ExplanationTxt>
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        <GrossRevenueEvent1Amt>154980</GrossRevenueEvent1Amt>
        <OtherDirectExpensesEvent1Amt>40512</OtherDirectExpensesEvent1Amt>
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        <GrossReceiptsTotalAmt>154980</GrossReceiptsTotalAmt>
        <GrossRevenueTotalEventsAmt>154980</GrossRevenueTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>40512</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>40512</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>114468</NetIncomeSummaryAmt>
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      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
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      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
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        <PersonNm>Mark Norman</PersonNm>
        <TitleTxt>Chief Operating Officer</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>66469</DeferredCompensationFlngOrgAmt>
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        <TotalCompensationFilingOrgAmt>715216</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Steven M Fontaine</PersonNm>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr James Devlin</PersonNm>
        <TitleTxt>director</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>223910</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Rhonda Halstead</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>30570</BonusFilingOrganizationAmount>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5404</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>25362</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Gregory Bauer</PersonNm>
        <TitleTxt>Chief Business Development Officer</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>15759</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>4267</OtherCompensationFilingOrgAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Julianne Peer</PersonNm>
        <TitleTxt>President, PHB</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <NontaxableBenefitsFilingOrgAmt>22553</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>330632</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>MARK NORMAN PARTICIPATED IN A A 457(F) PLAN CONTAINING EXCESS EMPLOYER CONTRIBUTIONS OVER THE 457(F) LIMIT. DURING CALENDAR YEAR 2024, THERE WERE NO INDIVIDUAL CONTRIBUTIONS TO THE PLAN AND NO DISTRIBUTIONS FROM THE PLAN. THE AMOUNT CONTRIBUTED TO THE PLAN BY THE ORGANIZATION DURING THE YEAR WAS $28,320.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 7 Non-fixed payments</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REPORTED AMOUNTS ON SCHEDULE J, PART II, COLUMN B(II) THAT QUALIFY AS NON-FIXED PAYMENTS. WHILE THE AMOUNTS ARE BASED ON CERTAIN PRESET METRICS, THERE IS DISCRETION OVER DECIDING WHETHER TO MAKE THE PAYMENT, AS THE AMOUNTS ARE SUBJECT TO FINAL APPROVAL. THE AMOUNTS PAID TO PRESIDENTS ARE APPROVED BY THE BOARD, WHILE THE AMOUNTS PAID TO KEY EMPLOYEES ARE APPROVED BY THE PRESIDENTS.</ExplanationTxt>
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        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>13555000</RetiredAmt>
        <TotalProceedsAmt>168594544</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>1514726</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>96494270</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>70585548</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2022</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>false</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>false</EngageBondCounselResearchInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>false</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</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>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column (a)</FormAndLineReferenceDesc>
        <ExplanationTxt>TAX-EXEMPT BONDS: THE TAX-EXEMPT BONDS LISTED ON SCHEDULE K WERE ISSUED FOR THE BENEFIT OF THE TAX-EXEMPT ENTITIES INCLUDED IN THE AFFILIATED SYSTEM OF PENN HIGHLANDS HEALTHCARE, INCLUDING THE FOLLOWING: PENN HIGHLANDS DUBOIS PENN HIGHLANDS ELK PENN HIGHLANDS BROOKVILLE PENN HIGHLANDS HUNTINGDON JEFFCO HEALTH SERVICES COMMUNITY NURSES, INC. PENN HIGHLANDS MON VALLEY SCHEDULE K HAS BEEN PREPARED FOR PENN HIGHLANDS HEALTHCARE AND INCLUDES PROCEEDS OF THE 2018 TAX-EXEMPT BOND, OF WHICH THE BALANCE IS SHOWN ON THE BALANCE SHEETS OF THE RELATED TAX-EXEMPT ORGANIZATIONS ABOVE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part IV, Line 2c COLUMN A</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer name: HOSPITAL AUTHORITY OF THE CITY OF DUBOIS The calculation for computing no rebate due was performed on 07/15/2022</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="24020961" softwareVersionNum="2024v5.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1a Material differences in voting rights</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing body delegates broad authority to an executive committee. The executive committee consists of 5 members, including the Chair, the Vice Chair, the Treasurer, the Secretary, and the CEO. The Chair of the Board serves as the chair of the Executive Committee. In the event of an urgent or emergent situation, the Executive Committee may transact any business that would normally require Board approval between regularly scheduled Board meetings provided that these actions are subsequently ratified by the board. The Executive Committee does not have the authority to approve the nomination or removal of directors, amendments to articles or bylaws, approval of the strategic plan, or the hiring, firing or sanctioning of the CEO or a material change in the CEO's compensation and benefits.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 2 Family/business relationships amongst interested persons</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATED TRUSTEES AND OFFICERS SHARE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION. - Business relationship</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>POWER TO ELECT OR APPOINT BOARD: THE BOARD IS COMPRISED OF INDIVIDUALS APPROVED BY RELATED TAX-EXEMPT ORGANIZATIONS PENN HIGHLANDS DUBOIS, PENN HIGHLANDS CLEARFIELD, PENN HIGHLANDS BROOKVILLE, PENN HIGHLANDS ELK, PENN HIGHLANDS HUNTINGDON, PENN HIGHLANDS JEFFERSON MANOR AND TYRONE HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE DRAFT FORM 990 IS REVIEWED BY THE CFO AND THE system CONTROLLER. AFTER ALL SUGGESTED CHANGES FROM THE CFO AND system CONTROLLER ARE MADE, THE UPDATED DRAFT FORM 990 IS PROVIDED FOR REVIEW TO THE FULL BOARD. ANY QUESTIONS OR COMMENTS FROM THE BOARD ARE ADDRESSED BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY: PENN HIGHLANDS HEALTHCARE, INC. (PHH), MAINTAINS A CONFLICT OF INTEREST POLICY WHICH APPLIES TO ALL SUBSIDIARIES. THE CONFLICT OF INTERESTS POLICY APPLIES TO BOARD MEMBERS, OFFICERS, EXECUTIVE EMPLOYEES, AND ANY OTHER MANAGER OR SUPERVISOR EXERCISING SUBSTANTIAL INFLUENCE OVER OPERATIONS. EACH COVERED PERSON WILL PROMPTLY AND FULLY DISCLOSE ALL MATERIAL FACTS OF EVERY ACTUAL OR POTENTIAL DUAL INTEREST EXISTING AT THE TIME WHEN HE/SHE BECOMES A COVERED PERSON, AND ANNUALLY THROUGH EACH PHH SYSTEM ENTITY'S DISCLOSURE STATEMENT, WHICH REQUESTS DISCLOSURE OF RELATIONSHIPS, INVESTMENTS, AND TRANSACTIONS THAT MAY LEAD TO AN ACTUAL CONFLICT OF INTEREST. ALL COMPLETED DISCLOSURE STATEMENTS WILL BE PROVIDED TO THE PHH GOVERNANCE/NOMINATING COMMITTEE. THIS COMMITTEE, IN CONSULTATION WITH THE CHAIRPERSON OR VICE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD, SHALL EVALUATED THE COMPLETED DISCLOSURE STATEMENTS AND DETERMINE IF THERE ARE ANY CONFLICTS THAT ARE SO PERVASIVE AS TO RENDER ANY COVERED PERSON INELIGIBLE FOR SERVICE. THE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD WILL DISCLOSE TO THE FULL BOARD OF SAID PHH SYSTEM ENTITY ALL DUAL INTERESTS REPORTED TO HIM OR HER UNDER THE POLICY AND WILL ALSO MAKE THE DISCLOSURE STATEMENTS OF ALL COVERED PERSONS AVAILABLE TO DIRECTORS AT ANY TIME DURING THE YEAR. IF A POTENTIAL DUAL INTEREST ARISE AS A RESULT OF A CONTEMPLATED PHH SYSTEM ENTITY BOARD (OR COMMITTEE) ACTION, THE CHAIRPERSON OF SAID PHH SYSTEM ENTITY'S BOARD OF THE INTERESTED PERSON SHALL, OR ANY OTHER DIRECTOR MAY, RAISE THE QUESTION OF THE INTERESTED PERSON'S DUAL INTEREST. THE DISINTERESTED MEMBERS OF THE PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) WILL EVALUATED THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION, ARRANGEMENT, OR POLICY GIVING RISE TO THE DUAL INTEREST TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION, ARRANGEMENT, OR POLICY. A COVERED PERSON WHO HAS A DUEL INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE A PRESENTATION TO SAID BOARD (OR COMMITTEE), TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. IF A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE DETERMINES THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON SHALL BE SO ADVISED AND THE CHAIRPERSON OF A PHH SYSTEM ENTITY'S BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE OR DIRECT MANAGEMENT TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, IF THIS HAS NOT ALREADY BEEN DONE. ANY INTERESTED PERSON WHO HAS AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING ANY SUCH TRANSACTION OR ARRANGEMENT. IF AN INDIVIDUAL WHOSE COMPANY OR EMPLOYER HAS A BUSINESS RELATIONSHIP WITH A PHH SYSTEM ENTITY, BUT THE INDIVIDUAL DOES NOT HAVE AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THIS BUSINESS RELATIONSHIPS, THE INDIVIDUAL MAY NONETHELESS VOLUNTARILY RECUSE HIM/HERSELF FROM VOTING ON ANY MATTERS RELATED TO THE RELATIONSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PENN HIGHLANDS HEALTHCARE (PHH) EXECUTIVE COMPENSATION COMMITTEE CONSULTS WITH THE HEALTHCARE CONSULTING FIRM, YAFEE &amp; COMPANY TO OBTAIN COMPARABLE DATA TO MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS REGARDING EXECUTIVE COMPENSATION. THE PENN HIGHLANDS HEALTHCARE BOARD OF DIRECTORS IS ACUTELY AWARE OF THE HEIGHTENED PUBLIC SCRUTINY OF EXECUTIVE COMPENSATION AND THE NEED TO CONSIDER REGULATORY COMPLIANCE WHEN SETTING EXECUTIVE PAY. COMPENSATION REVIEWS ARE DONE ON A CONTINUOUS BASIS. COMPENSATION DETERMINATIONS OF PHH EMPLOYED OFFICERS ARE MADE BY THE PHH COMPENSATION COMMITTEE. COMPENSATION DETERMINATIONS OF CERTAIN EMPLOYED OFFICERS ARE ALSO REVIEWED AND APROVED BY THE PHH COMPENSATION COMMITTEE AND SHARED WITH THE COMPENSATION COMMITTEE OR BOARD. THE COMPENSATION COMMITTEE OF PHH STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE PHH EXECUTIVE COMPENSATION COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE PHH BOARD ON A CONTINUOUS BASIS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES, AS APPLICABLE, EXPRESSLY DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARD OF PHH, AS APPLICABLE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENT AVAILABILITY: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>PROF FEES -PHYS-MED DIR/OTH - Total Expense: 15486, Program Service Expense: 13473, Management and General Expenses: 2013, Fundraising Expenses: ; PHYSICIAN RECRUITMENT - Total Expense: 8697, Program Service Expense: 7566, Management and General Expenses: 1131, Fundraising Expenses: ; CONSULTANTS - Total Expense: 3985444, Program Service Expense: 3467336, Management and General Expenses: 518108, Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 96177, Program Service Expense: 83674, Management and General Expenses: 12503, Fundraising Expenses: ; COLLECTION FEES - Total Expense: 1158943, Program Service Expense: 1008280, Management and General Expenses: 150663, Fundraising Expenses: ; OUTSIDE SERVICES - Total Expense: 17290937, Program Service Expense: 15043115, Management and General Expenses: 2247822, Fundraising Expenses: ; FOOD - Total Expense: 251417, Program Service Expense: 218733, Management and General Expenses: 32684, Fundraising Expenses: ; RECRUITMENT - Total Expense: 511220, Program Service Expense: 444761, Management and General Expenses: 66459, Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSFERS TO AFFILIATES - 18732685; FUNDRAISING EVENT ADJUSTMENT - -114468; Total - 18618217;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION</FormAndLineReferenceDesc>
        <ExplanationTxt>NO TRUSTEES RECEIVE ANY COMPENSATION FOR THEIR TRUSTEE DUTIES. DR. THOMAS CARNEVALE IS COMPENSATED AS A PHYSICIAN AT PENN HIGHLANDS DUBOIS. STEVE FONTAINE IS COMPENSATED AS CEO OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. DOUGLAS WINNER IS COMPENSATED AS CFO OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. DR. RUSS CAMERON IS COMPENSATED AS CHIEF MEDICAL INFORMATION OFFICER OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. MARK NORMAN IS COMPENSATED AS CHIEF OPERATING OFFICER OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. DR. TRINA ABLA IS COMPENSATED AS CHIEF MEDICAL OFFICER OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. DONALD CONRAD AND JAMES DEVLIN ARE COMPENSATED AS EMPLOYEES AND/OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR A RELATED ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PURPOSE FOR THE AFFILIATION IS TO ENSURE THE ACCESSIBILITY OF HEALTH CARE SERVICES IN THE CLEARFIELD, DUBOIS, ELK AND BROOKVILLE AREAS, ENHANCE ACCESS TO HIGH-QUALITY PATIENT CARE FACILITIES FOR PATIENTS AND MEDICAL STAFFS OF THE HOSPITALS, OFFER A BROADER RANGE OF SERVICES AND CREATE COST EFFICIENCIES IN THE DELIVERY OF HEALTH CARE SERVICES TO THE COMMUNITY. PENN HIGHLANDS HEALTHCARE EXERCISES A SUBSTANTIAL DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS AND ACTIVITIES OF THE SUPPORTED ORGANIZATIONS AND THE OTHER SUBSIDIARIES, INCLUDING OVERSEEING AND IMPLEMENTING A SYSTEM-WIDE CONFLICT OF INTEREST POLICY AND PASTORAL CARE PROGRAM.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="24020961" softwareVersionNum="2024v5.1">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PENN HIGHLANDS NATURAL THERAPIES LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO BOX 447 100 HOSPITAL AVE</AddressLine1Txt>
          <CityNm>DUBOIS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15801</ZIPCd>
        </USAddress>
        <EIN>820776018</EIN>
        <PrimaryActivitiesTxt>INVESTMENTS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <TotalIncomeAmt>-203</TotalIncomeAmt>
        <EndOfYearAssetsAmt>334669</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S PHARMACY</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4 RAILROAD ST</AddressLine1Txt>
          <CityNm>ST MARYS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15857</ZIPCd>
        </USAddress>
        <EIN>251211032</EIN>
        <PrimaryActivitiesTxt>PHARMACY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <TotalIncomeAmt>-559278</TotalIncomeAmt>
        <EndOfYearAssetsAmt>9524573</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>DUBOIS REGIONAL MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 HOSPITAL AVENUE</AddressLine1Txt>
          <CityNm>DUBOIS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15801</ZIPCd>
        </USAddress>
        <EIN>251490707</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ELCO HOUSING</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>759 JOHNSONBURG ROAD</AddressLine1Txt>
          <CityNm>ST MARYS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15857</ZIPCd>
        </USAddress>
        <EIN>251639115</EIN>
        <PrimaryActivitiesTxt>HOUSING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ELK REGIONAL HEALTH CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>763 JOHNSONBURG ROAD</AddressLine1Txt>
          <CityNm>ST MARYS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15857</ZIPCd>
        </USAddress>
        <EIN>250585280</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ELK REGIONAL PROESSIONAL GROUP INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>764 JOHNSONBURG ROAD</AddressLine1Txt>
          <CityNm>ST MARYS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15858</ZIPCd>
        </USAddress>
        <EIN>251875183</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMUNITY NURSES HOME HEALTH &amp; HOSPICE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>761 JOHNSONBURG ROAD</AddressLine1Txt>
          <CityNm>ST MARYS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15857</ZIPCd>
        </USAddress>
        <EIN>250996070</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CNI</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMUNITY NURSES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>762 JOHNSONBURG ROAD</AddressLine1Txt>
          <CityNm>ST MARYS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15857</ZIPCd>
        </USAddress>
        <EIN>251623598</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMMUNITY NURSES HOME SUPPORT SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>763 JOHNSONBURG ROAD</AddressLine1Txt>
          <CityNm>ST MARYS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15857</ZIPCd>
        </USAddress>
        <EIN>251623601</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>CNI</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>DRMC EMPLOYEE BENEFITS PLAN TRUST</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 HOSPITAL AVENUE</AddressLine1Txt>
          <CityNm>DUBOIS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15801</ZIPCd>
        </USAddress>
        <EIN>256332829</EIN>
        <PrimaryActivitiesTxt>DRMC EMP BENE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(9)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>DRMC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>JEFFCO HEALTH SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>417 ROUTE 28</AddressLine1Txt>
          <CityNm>BROOKVILLE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15825</ZIPCd>
        </USAddress>
        <EIN>251505478</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BROOKVILLE</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>JC BLAIR MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1225 WARM SPRINGS AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGDON</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16652</ZIPCd>
        </USAddress>
        <EIN>231352159</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>JC BLAIR MEMORIAL HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>935 14TH STREET</AddressLine1Txt>
          <CityNm>HUNTINGDON</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16652</ZIPCd>
        </USAddress>
        <EIN>251881377</EIN>
        <PrimaryActivitiesTxt>SUPPORT HOSP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>DRMC WORKERS COMPENSATION TRUST</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>809 TURNPIKE DR</AddressLine1Txt>
          <CityNm>CLEARFIELD</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16830</ZIPCd>
        </USAddress>
        <EIN>250979346</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HELPMATES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>250 WEST MAIN STREET</AddressLine1Txt>
          <CityNm>RIDGEWAY</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15853</ZIPCd>
        </USAddress>
        <EIN>251555968</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>CNI</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PENN HIGHLANDS TYRONE</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>187 HOSPITAL DRIVE</AddressLine1Txt>
          <CityNm>TYRONE</CityNm>
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          <ZIPCd>16686</ZIPCd>
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        <EIN>231440116</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TYRONE REGIONAL HEALTH NETWORK FOUNDATIO</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>187 HOSPITAL DRIVE</AddressLine1Txt>
          <CityNm>TYRONE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16686</ZIPCd>
        </USAddress>
        <EIN>814504606</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PH TYRONE</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HIGHLANDS HOSPITAL</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>401 EAST MURPHY AVENUE</AddressLine1Txt>
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          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15425</ZIPCd>
        </USAddress>
        <EIN>251494705</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HIGHLANDS HOSPITAL FOUNDATION</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>401 EAST MURPHY AVENUE</AddressLine1Txt>
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          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15425</ZIPCd>
        </USAddress>
        <EIN>843713870</EIN>
        <PrimaryActivitiesTxt>SUPPORT HOSP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WRC HEALTH CARE SUPPORT SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>985 ROUTE 28</AddressLine1Txt>
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          <ZIPCd>15825</ZIPCd>
        </USAddress>
        <EIN>251601734</EIN>
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          <BusinessNameLine1Txt>WRC SR SRVCS</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>WRC SENIOR SERVICES</BusinessNameLine1Txt>
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          <AddressLine1Txt>985 ROUTE 28</AddressLine1Txt>
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          <BusinessNameLine1Txt>DRMC</BusinessNameLine1Txt>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>WRC NORTH FORK HEIGHTS</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>985 ROUTE 28</AddressLine1Txt>
          <CityNm>BROOKVILLE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15825</ZIPCd>
        </USAddress>
        <EIN>251684846</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>WRC SR SRVCS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WRC PENNSYLVANIA MEMORIAL HOME</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>985 ROUTE 28</AddressLine1Txt>
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          <BusinessNameLine1Txt>WRC SR SRVCS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MONONGAHELA VALLEY HOSPITAL FOUNDATION</BusinessNameLine1Txt>
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          <ZIPCd>15063</ZIPCd>
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        <EIN>825336533</EIN>
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          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MONONGAHELA VALLEY HOSPITAL INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1163 COUNTRY CLUB ROAD</AddressLine1Txt>
          <CityNm>MONONGAHELA</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15063</ZIPCd>
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          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>BROOKVILLE HOSPITAL</BusinessNameLine1Txt>
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          <AddressLine1Txt>100 HOSPITAL RD</AddressLine1Txt>
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          <BusinessNameLine1Txt>DUBOIS REGIONAL MEDICAL GROUP</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>100 HOSPITAL AVENUE</AddressLine1Txt>
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          <ZIPCd>15801</ZIPCd>
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          <AddressLine1Txt>100 HOSPITAL AVENUE</AddressLine1Txt>
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          <BusinessNameLine1Txt>BROOKCARE II INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>100 HOSPITAL ROAD</AddressLine1Txt>
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        <PrimaryActivitiesTxt>LEASE OFFICE SPAC</PrimaryActivitiesTxt>
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          <AddressLine1Txt>PO BOX 447 100 HOSPITAL AVE</AddressLine1Txt>
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          <BusinessNameLine1Txt>PREMIER HEALTH CARE STAFFING INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>100 HOSPITAL AVENUE</AddressLine1Txt>
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          <BusinessNameLine1Txt>JC BLAIR MEDICAL SERVICES INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>1225 WARM SPRINGS AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGDON</CityNm>
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          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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