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      <Desc>INPATIENT SERVICES - MARION GENERAL HOSPITAL (MGH) OPERATES A 82-ACUTE CARE BED FACILITY, ALONG WITH AN 18-BED ACUTE REHABILITATION UNIT. INPATIENT SERVICES PROVIDED INCLUDE: MEDICAL/SURGICAL/TELEMETRY, CRITICAL, PEDIATRIC, OBSTETRIC, NEWBORN AND ACUTE REHABILITATION CARE. ADDITIONAL SERVICES PROVIDED TO INPATIENTS INCLUDE SURGERY, LABORATORY, RESPIRATORY THERAPY, PHYSICAL MEDICINE, CARDIOVASCULAR SERVICES AND RADIOLOGY. MARION GENERAL HOSPITAL DISCHARGED 4,157 INPATIENT ADULT AND PEDIATRIC PATIENTS AND PROVIDED 15,482 INPATIENT ADULT AND PEDIATRIC PATIENT CARE DAYS DURING THE YEAR ENDED JUNE 30, 2025. DURING THE SAME TIME PERIOD, MGH ALSO DISCHARGED 206 AND PROVIDED 2,093 PATIENT CARE DAYS FOR PATIENTS IN THE ACUTE REHAB UNIT. THERE WERE 380 DELIVERIES PERFORMED.</Desc>
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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>136250</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Shankaran Srikanth MD</PersonNm>
        <TitleTxt>Physician/VC of Medical Staff</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>564026</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>47405</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Sirajabid Khatib MD</PersonNm>
        <TitleTxt>Physician/Board Member</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>365939</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29083</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stephen Keller MD</PersonNm>
        <TitleTxt>Physician/Board Member</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>610304</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>60219</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Anthony Roberts</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>50.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>391538</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>47243</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cynthia Futrell</PersonNm>
        <TitleTxt>CNO</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>304612</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>46540</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Charles Cossell DO</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27732</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Daniel Edwards MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>619044</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26542</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Douglas Rex DO</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>632745</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35542</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Edmund Bendaly MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>1006942</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10350</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kavita Raj DO</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>659544</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>50647</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>8391161</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>483157</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>184</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CROTHALL HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>955 CHESTERBROOK BLVD</AddressLine1Txt>
            <CityNm>WAYNE</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19087</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>OUTSIDE MGMT SERVICE</ServicesDesc>
        <CompensationAmt>8464851</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AYA HEALTHCARE INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5930 CORNERSTONE CT WEST</AddressLine1Txt>
            <CityNm>SAN DIEGO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92121</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT STAFFING</ServicesDesc>
        <CompensationAmt>5917524</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ELIOR INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>300 S TRYON STREET</AddressLine1Txt>
            <CityNm>CHARLOTTE</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>28202</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>OUTSIDE MGMT SERVICE</ServicesDesc>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ICELAND ANESTHESIA MGMT</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1765 E NINE MILE ROAD</AddressLine1Txt>
            <AddressLine2Txt>STE 1-229</AddressLine2Txt>
            <CityNm>PENSACOLA</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>32514</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHYSICIAN COVERAGE</ServicesDesc>
        <CompensationAmt>3459662</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WEATHERBY LOCUMS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6451 N FEDERAL HWY</AddressLine1Txt>
            <AddressLine2Txt>SUITE 700</AddressLine2Txt>
            <CityNm>FORT LAUDERDALE</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>33308</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHYSICIAN COVERAGE</ServicesDesc>
        <CompensationAmt>2137526</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>69</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>1104233</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>356819</AllOtherContributionsAmt>
      <TotalContributionsAmt>1461052</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT REVENUE</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>241687888</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>241687888</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MED DIRECTOR SERVICES</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>416841</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>416841</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>VHA DIVIDEND</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>378401</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>378401</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAL RECORDS</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>118154</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>118154</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ALL OTHER</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>1989368</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1989368</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>244590652</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
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        <ExclusionAmt>8538808</ExclusionAmt>
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      <GrossRentsGrp>
        <RealAmt>619959</RealAmt>
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      <LessRentalExpensesGrp>
        <RealAmt>3762541</RealAmt>
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      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
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        <ExclusionAmt>-3142582</ExclusionAmt>
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      <GrossAmountSalesAssetsGrp>
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        <SecuritiesAmt>3848859</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>15307247</SecuritiesAmt>
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      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>15308997</TotalRevenueColumnAmt>
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      <FundraisingGrossIncomeAmt>4386</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>15</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>4371</TotalRevenueColumnAmt>
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      </NetIncmFromFundraisingEvtGrp>
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        <Desc>BILLING SERVICES</Desc>
        <BusinessCd>541900</BusinessCd>
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        <UnrelatedBusinessRevenueAmt>34999</UnrelatedBusinessRevenueAmt>
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      <MiscellaneousRevenueGrp>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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      </MiscellaneousRevenueGrp>
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        <ProgramServicesAmt>365524</ProgramServicesAmt>
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        <ProgramServicesAmt>461504</ProgramServicesAmt>
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        <ProgramServicesAmt>56576240</ProgramServicesAmt>
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        <ProgramServicesAmt>9600956</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1659517</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>5036122</ProgramServicesAmt>
        <ManagementAndGeneralAmt>870489</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>584954</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>152600</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>44982</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>320294</ProgramServicesAmt>
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        <ProgramServicesAmt>15928865</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>33014931</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>PHYSICIAN SERVICES</Desc>
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        <ProgramServicesAmt>36704342</ProgramServicesAmt>
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        <Desc>PURCHASED SERVICES</Desc>
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        <ProgramServicesAmt>12423246</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>220377893</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25156153</ManagementAndGeneralAmt>
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        <EOYAmt>30899100</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>31840621</EOYAmt>
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        <EOYAmt>159969</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>1664893</EOYAmt>
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        <EOYAmt>2954729</EOYAmt>
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        <EOYAmt>4068728</EOYAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>155835691</EOYAmt>
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        <EOYAmt>204977551</EOYAmt>
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      <InvestmentsProgramRelatedGrp>
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        <EOYAmt>1188036</EOYAmt>
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      <IntangibleAssetsGrp>
        <BOYAmt>1555298</BOYAmt>
        <EOYAmt>1654239</EOYAmt>
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        <BOYAmt>6699682</BOYAmt>
        <EOYAmt>7893097</EOYAmt>
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        <ImplementationStrategyAdptYr>25</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>https://www.marionhealth.com/documents/Marion-Health-Implemention-Plan-2023-2026.pdf</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>200.0</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>350.0</FPGFamilyIncmLmtDscntCarePct>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>WWW.MARIONHEALTH.COM</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>WWW.MARIONHEALTH.COM</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>WWW.MARIONHEALTH.COM</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
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        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicaidMedcrPrvtInd>X</LookBackMedicaidMedcrPrvtInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 5 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - MARION GENERAL HOSPITAL. The link to the survey summary link is provided to email groups, including business, not-for- profit organizations, Grant County Health Board, Marion City Council, Indiana Wesleyan University, Taylor University, and IVY Tech Community College. Organizations that Marion Health has working partnerships such as: Bridges to Health, Radiant Health, Veterans Hospital, Systems of Care, area FQHC's (Indiana Health Center and Meridian Health). The CORE+, which includes recovery houses, medication assisted recovery programs and services addressing social determinants of health. K-12 schools are part of the Breathe Easy Coalition which is continually updated area data on tobacco, nicotine and other related health issues. Information has been made available to the cancer committee, which is sponsored and convened by Marion Health - membership includes area home health, hospice, and related social services. The CHNA report is posted on Marion Health's website.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 6b Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - MARION GENERAL HOSPITAL. KATZ, SAPPER &amp; MILLER</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - MARION GENERAL HOSPITAL. The 2025 Community Needs assessment data, which includes primary and secondary data, confirms issues that our area has dealt with for many years. The health areas of most concern are: 1. Diabetes 2. Nutrition, weight control, and exercise 3. Lung Disease including nicotine prevention and cessation 4. Substance Use Disorder including alcohol, tobacco, opioids, etc. 5. Heart Health 6. Oral Dental Health including access to low-cost dental care A complicating factor is that many people have several diagnoses, making chronic disease the highest concern. Marion Health has added additional staff for our diabetes and nutrition program. Community outreach through the partnership with the Second Harvest Food Bank program has allowed additional teaching and cooking demonstrations for our community, with strong focus on schools and parents. Focus on outpatients with remote patient monitoring for those with heart and diabetic issues has improved quality of life for those participating. We have Increased attention to prenatal and postnatal women for diabetes and blood pressure issues by providing monitoring tools for at home use. Grant funds have been provided to assist with remote patient monitoring. The heart failure clinic has added community health workers that have frequent contact with clients, which leads to increased adherence to medications and monitoring. Marion Health developed and continues to expand a chronic disease follow-up with patients upon discharge from the hospital to ensure continuum of care and assure discharge plans are appropriate and timely for regaining health. Also facilitated by the community health workers, Marion Health has expanded our pulmonary function testing to provide earlier intervention for lung issues. Marion Health has a Tobacco and Nicotine cessation specialist, who has made great strides with local schools in particular, for e-cigarettes/vaping, which had been skyrocketing. Local athletes have been challenged to provide leadership in resisting tobacco and nicotine products among other students. Additional efforts have been made to continue to encourage no smoking in bars and area festivals and parks. The partnership with Second Harvest provides additional platforms to promote nutrition and education about fresh foods. Farm to school access is being explored as an additional partnership resource. Marion Health works with Grant County Extension in their efforts with cooking demonstrations. Grant County, City of Marion and many local churches are continuing to add options for physical health and exercise through expansion of local bike and walking trails with increased safety, addition of pickleball courts, frisbee golf, splash pads, and exercise stations. Several Churches within Marion health Parish Nurse program have added volleyball and pickleball to their indoor facilities, and have partnered with or added food banks. Mental Health and Substance use disorder services and programs are still overwhelmed and have long waiting lists for therapy and intervention. The addition of the Marion Health primary care practice mental health program has provided a much needed option for testing for ADHD, Autism and several other diagnosis. Marion Health is the only testing site that identifies disorders that if left undiagnosed or misdiagnosed can often lead to substance abuse. Immediate access from a primary care appointment has promoted earlier intervention with treatment and referrals. This program is also supporting medication assisted recovery (new in FY25) and outpatient therapy programs. Marion Health has recently added a physician with Addictions Medicine as a specialty to oversee outpatient intensive Therapy. Marion Health provides two psychologists and two specialized therapists equipped to test, screen and determine a diagnosis for patients. The most crucial social detriment of health that impacts our population continues to be poverty, single parent homes, and children living in poverty. This is complicated by our high addiction rates. Marion Health sponsors and facilitates the Suicide and Overdose Fatality Review Team, which has and continues to provide insight as to needed and or to strengthen interventions. A play therapy grief program for children, a support group for grief and caregivers have been added because of this team. Currently, additional opioid funds are in progress for additional programming for substance abuse treatment. Marion Health provides a patient assistance program for those who struggle with payment for health care. Marion Health has a robust partnership and assists with a local free clinic (Bridges to Health) that provides primary care, medications and durable medical equipment at no charge. Chronic disease, poverty, lack of access for primary care, mental health care and specialty care compound quantity and quality of life. Marion Heath is in its second year of a family medicine residency program, which is already providing additional primary care for many individuals and holds promise to retain physicians for Grant County. Grant county is designated by HRSA as Medically Underserved Area, Health Professional Shortage area and mental health provider shortage. The dental issue is slowly improving as Marion Health was instrumental in bringing an FQHC dental clinic with sliding fees to Grant County, and due to the need that clinic now has 2.5 FTE dentists serving low income clients.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>25</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH SURGERY CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>330 N WABASH AVENUE STE 200</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT SURGERY CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH PEDIATRIC CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>330 N WABASH AVENUE STE 320</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>UROLOGY CENTER OF MGH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>330 N WABASH AVENUE STE 350</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MARION SURGEONS</BusinessNameLine1Txt>
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          <USAddress>
            <AddressLine1Txt>330 N WABASH AVENUE STE 370</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>LUNG CENTER OF MGH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>330 N WABASH AVENUE STE 450</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FAMILY MEDICINE CENTER-MARION</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>330 N WABASH AVENUE STE 430</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH SLEEP LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1387 N BALDWIN AVENUE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>SLEEP LAB</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH DIAGNOSTICS-NORTHWOOD</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1379 N BALDWIN AVENUE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>LAB</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FAMILY MEDICINE CENTER-NORTHWOOD</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1399 N BALDWIN AVENUE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH PHYSICAL MEDICINE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1393 N BALDWIN AVENUE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MARION FAMILY PRACTICE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1391 N BALDWIN AVENUE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH DIAGNOSTICS-SOUTH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1408 W BELLA DRIVE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46953</ZIPCd>
          </USAddress>
          <FacilityTxt>LAB</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FAMILY MEDICINE CENTER-SOUTH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1406 W BELLA DRIVE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46953</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>OBSTETRICS AND GYNECOLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1419 W BELLA DRIVE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46953</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH MEDICAL ONCOLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>831 N THEATRE DRIVE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>MEDICAL ONCOLOGY, PHYSICIAN OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH WORK SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1136 N BALDWIN AVENUE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>OCCUPATIONAL MEDICINE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FAMILY MEDICINE CENTER-CONVERSE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>308 N JEFFERSON STREET</AddressLine1Txt>
            <CityNm>CONVERSE</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46919</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FAMILY MEDICINE CENTER-SWAYZEE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2651 S 800 S</AddressLine1Txt>
            <CityNm>SWAYZEE</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46986</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FAMILY MEDICINE CENTER-GAS CITY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4751 KAY BEE DRIVE</AddressLine1Txt>
            <CityNm>GAS CITY</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46933</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH DIAGNOSTICS-GAS CITY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4751 KAY BEE DRIVE</AddressLine1Txt>
            <CityNm>GAS CITY</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46933</ZIPCd>
          </USAddress>
          <FacilityTxt>LAB</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>FAIRMOUNT MEDICAL ASSOCIATES</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>157 W 8TH STREET</AddressLine1Txt>
            <CityNm>FAIRMOUNT</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46928</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH EXPRESS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1130 N BALDWIN AVENUE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>URGENT CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH RESIDENCY CLINIC-FAMILY MEDICINE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1389 N BALDWIN AVENUE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46952</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MGH ORTHOPEDICS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1406 W BELLA DRIVE</AddressLine1Txt>
            <CityNm>MARION</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46953</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MARION HEALTH EAST</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>911 MARION HEALTH DRIVE</AddressLine1Txt>
            <CityNm>GAS CITY</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46933</ZIPCd>
          </USAddress>
          <FacilityTxt>HOSPITAL</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 COLUMN (F)</FormAndLineReferenceDesc>
        <ExplanationTxt>$15,928,865 of bad debt expense is included in Form 990, Part IX, Line 25 total expenses, but it is subtracted for purposes of calculating the amount entered on Schedule H, Part I, Line 7, Column (f).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7g Subsidized Health Services</FormAndLineReferenceDesc>
        <ExplanationTxt>FOR THE CONGESTIVE HEART FAILURE CLINIC, EXPENSES OF $419,037 WERE OFFSET BY REVENUES OF $168,845 TO END WITH A SUBSIDY AMOUNT OF $250,192.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation</FormAndLineReferenceDesc>
        <ExplanationTxt>15928865</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>USED ACTUAL DOLLARS SPENT</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part II Community Building Activities</FormAndLineReferenceDesc>
        <ExplanationTxt>Marion General Hospital DBA Marion Health (MH) is committed to responding to the federal designations that Grant County is a medical profession shortage area (MPSA) and medically underserved area (MUSA). Active recruiting and loan forgiveness (as incentives) for provider hiring are critical to serving our healthcare communities. A newly acquired HRSA loan forgiveness and scholarship program for physicians and nurse practitioners will be a great asset to enhance recruiting to our rural community. The need for recruiting and retaining providers presents significant challenges for a small rural area. Marion Health is in the second year of a Family Medicine Residency Program with 13 physicians seeing patients in the resident clinic. An additional 6 physicians will be added in summer of 2026. Marion Health is actively exploring options for telehealth with exam technology for specialties that are not available in our area at the Marion Health East location. Marion General Hospital DBA Marion Health continues to develop our new state-of-the-art, Innovation Campus, which is located in the lowest economic township of our service area. MH Coordinator of the Tobacco Cessation Program has impacted adults and students use, and our numbers of tobacco users have decreased in our region.(IDOH) Specific health education attention has been given to students who are vaping, due to recognition through the Indiana Department of Health data revealing excessive youth using nicotine products particularly e-cigarettes. Representatives from MH serve on the Indiana Wesleyan University (IWU) School of Nursing Community Advisory Board and the Community Advisory Board for Occupational Therapy. MH representatives have been instrumental in working with IWU to create graduate education programs that meet community provider needs. MH also has representatives on the Grant County Extension program, Radiant Health, and Head Start. Marion Health is partnering with IVY Tech to increase workforce and low-cost education options for area students. MH also partners with CORE + (Community Opioid Response Endeavor) consortium to provide services for people in active addiction, treatment, and rehab. The CORE + Consortium under MH leadership has facilitated free community based Narcan boxes to address the high numbers of overdoses. MH is the largest support of our county's free health and dental clinic, Bridges to Health. State opioid funds continue to support a Mental/behavioral health emphasis for primary care providers, adding an additional addictions service for outpatients including medication assisted recovery. This program, which provides two psychologists and two therapists, has addressed the needs identified while patients are in a primary care visit who are having difficulty obtaining mental/behavior health services due to significant waiting times for other community mental/behavior health providers. This program provides the only testing site for Grant County for ADHA, Autism and other mental health diagnosis. This program has added to early diagnosis and intervention for patients. Chronic illness remains in high numbers, MH has a program to use telehealth at home, and community health workers are available for home visits and assessments to provide greater intervention resources for people with multiple diagnoses at no charge to the patient. The hospital donates in-kind and monetary gifts to local not-for-profit organizations that assist in the mission to improve the health in Grant County.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT AT COST IS ESTIMATED BY MULTIPLYING TOTAL PROVISION FOR BAD DEBT FOR THE YEAR BY THE AVERAGE COST-TO-CHARGE RATIO AS DERIVED FROM THE FILED MEDICARE COST REPORT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 3 Bad Debt Expense Methodology</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICIES IS ESTIMATED BASED UPON PAST EXPERIENCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE PAGE 12 OF THE ATTACHED FINANCIAL STATEMENTS, UNDER THE HEADING PATIENT SERVICE REVENUE, RELATED RECEIVABLES AND ESTIMATED SETTLEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 8 Community benefit &amp; methodology for determining medicare costs</FormAndLineReferenceDesc>
        <ExplanationTxt>MARION HEALTH BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED WHEN ATTEMPTING TO REFLECT THE FINANCIAL BENEFIT THAT THE ORGANIZATION PROVIDES TO ITS COMMUNITY. TO THAT END, MARION HEALTH SHOWS THIS AMOUNT SEPARATELY ON ITS ANNUAL COMMUNITY BENEFIT REPORT. SERVICES ARE PROVIDED TO MEDICARE PATIENTS BY MARION HEALTH WHILE, AT THE SAME TIME, WE FULLY EXPECT TO RECEIVE LESS IN REIMBURSEMENT THAN IT COSTS TO PROVIDE THESE SERVICES. WE ARE BENEFITTING THE COMMUNITY BY BEING A CONVENIENT AND REPUTABLE SOURCE WITHIN THE COMMUNITY TO RECEIVE SUCH SERVICES. THE MEDICARE ALLOWABLE COSTS OF CARE IS TAKEN DIRECTLY FROM THE FILED MEDICARE COST REPORT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>MARION HEALTH'S COLLECTION POLICY DISTINGUISHES BETWEEN 'FINANCIAL ASSISTANCE' - PATIENTS UNABLE TO PAY, AND 'BAD DEBT' - PATIENTS UNWILLING TO PAY. MH SENDS A STATEMENT ON DAY 1 WITH AN EXPECTED DUE DATE OF ONE MONTH FROM THE DATE OF THE STATEMENT. ONE MONTH LATER A SECOND STATEMENT IS SENT FOLLOWED BY A LATE PAYMENT CALL. AT MONTH TWO ANOTHER STATEMENT IS SENT FOLLOWED BY ANOTHER CALL. BY MONTH THREE IF NO RESPONSE, AN ECA NOTIFICATION IS MAILED TO PATIENT NOTIFYING THEM THAT THE ACCOUNT MAY BE TURNED OVER TO COLLECTION. BY MONTH FOUR, IF NO RESPONSE THEN THE ACCOUNT MAY BE TURNED OVER TO COLLECTIONS. CALLS ARE DOCUMENTED IN THE AR SYSTEM FOR FURTHER FOLLOW-UP ACTION. PAYMENT IN FULL IS ALWAYS THE PREFERRED METHOD OF RESOLUTION FOR A SELF-PAY BALANCE. IF THIS IS NOT POSSIBLE, THE PATIENT FINANCIAL SERVICES REPRESENTATIVE OR FINANCIAL COUNSELOR PROVIDES INFORMATION TO THE PATIENT AND/OR OTHER RESPONSIBLE PARTY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM IN A WAY THAT IS EASY TO UNDERSTAND. THE PATIENT FINANCIAL SERVICE REPRESENTATIVE OR FINANCIAL COUNSELOR RESPONDS PROMPTLY TO QUESTIONS ABOUT THE PATIENT'S BILLS AND REQUESTS FOR ASSISTANCE. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT REPORTED TO A COLLECTION AGENCY AS LONG AS REQUESTED DOCUMENTATION IS PROVIDED TIMELY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16a FAP website</FormAndLineReferenceDesc>
        <ExplanationTxt>- MARION GENERAL HOSPITAL: Line 16a URL: WWW.MARIONHEALTH.COM;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16b FAP Application website</FormAndLineReferenceDesc>
        <ExplanationTxt>- MARION GENERAL HOSPITAL: Line 16b URL: WWW.MARIONHEALTH.COM;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16c FAP plain language summary website</FormAndLineReferenceDesc>
        <ExplanationTxt>- MARION GENERAL HOSPITAL: Line 16c URL: WWW.MARIONHEALTH.COM;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2 Needs assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>Marion General Hospital DBA Marion Health (MH) facilitates a county-wide community health profile (needs assessment) every three years. The survey process involves primary and secondary data. The most recent survey was done in partnership with Katz, Sapper &amp; Miller, CPAs and Advisors, 800 East 96th Street, Suite 500, Indianapolis, IN 46240, with questions derived from previous needs assessments and current best practice including all sectors of the community. The survey was shared throughout the county in electronic format. Additional information and data from various organizations were reviewed including the Grant County Health Department, Indiana Department of Health, CDC, County Health Rankings and Roadmaps, Indiana Cancer Registry, Indiana Youth Institute, and area needs assessments from local organizations. Data from the Community Health Needs Assessment (CHNA) and Marion Health staff regularly assist and inform the strategic care throughout the hospital, outpatient services, and community. The 2024/25 report has been approved by the board and will continue to be disseminated in the greater community, social service agencies, and key stakeholders.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3 Patient education of eligibility for assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE AS A NOT-FOR-PROFIT HOSPITAL, MH HAS SIGNAGE AT ALL REGISTRATION POINTS WITHIN THE FACILITY AND THE HOSPITAL'S BUSINESS OFFICE ADVISING THEM OF THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM (FAP). WE HAVE A BROCHURE TITLED 'UNDERSTANDING HOSPITAL BILLS AND INSURANCE' THAT DIRECTS THEM TO CALL US IF THEY DO NOT HAVE INSURANCE OR HAVE THE ABILITY TO PAY THEIR BILL. ALL BEDDED PATIENTS RECEIVE THIS BROCHURE UPON ADMISSION. WE ALSO HAVE A PATIENT NOTICE OF FINANCIAL ASSISTANCE POLICY STATEMENT AVAILABLE AT ALL REGISTRATION LOCATIONS AND THE BUSINESS OFFICE. OUR BILLING STATEMENTS ADVISE OUR PATIENTS THAT WE OFFER FINANCIAL ASSISTANCE AND DIRECTS THEM TO CONTACT US IN THE BUSINESS OFFICE TO GET ADDITIONAL INFORMATION AND AN APPLICATION ON OUR WEBSITE. ONCE A PATIENT IS APPROVED FOR ASSISTANCE, THEY ARE QUALIFIED FOR A PERIOD OF SIX MONTHS FROM APPROVAL OF THE APPLICATION. MH ALSO ASSISTS PATIENTS WITH THE COMPLETION OF THE FAP APPLICATION, AS WELL AS EVALUATION OF THEIR ELIGIBILITY FOR STATE AND FEDERAL GOVERNMENT BENEFIT PROGRAMS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4 Community information</FormAndLineReferenceDesc>
        <ExplanationTxt>Marion Health is the only non-government acute care hospital in rural Grant County, our primary geographic location. Grant County demographics are as follows: white 87.1%, black/African American 8.0%, multi-3.2%, Asian 1.2%. Latino/Hispanic 6.0%. Median income is $54,007, population is 66,458, 7.2% are without health insurance, and 17.9% of people live within poverty guidelines (www.census.gov updated on July 1, 2025). The Community Health Needs Assessment (CHNA every three years) is designed to gather information from all townships and people groups. Grant County is in north central Indiana. The county is designated rural by the U.S. Health Resources &amp; Services Administration and is the thirtieth largest county in Indiana 2i5h approximately 414.07 square miles in area and 0.82 square miles in water. Interstate 69 runs along the entire eastern boundary of the county, and the Mississinewa River runs from the southeast to the northwest through the center of the county.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5 Promotion of community health</FormAndLineReferenceDesc>
        <ExplanationTxt>Marion Health makes a concentrated effort to provide primary care locations in most towns of the county. The practitioner referral line, Marion Health ACCESS, assists patients to schedule immediate primary care appointments. Much time, effort, and money are needed to recruit physicians, physician extenders, and other health care team members for our rural area. Staff members and leaders serve on countless boards across the county to extend the mission, "transforming the health of our community". Marion Health Community Outreach staff offer education and health screenings for area provider offices, not-for-profit organizations, school nurses, area social workers, and multiple university student groups. Marion Health has partnered with Second Harvest - a food insecurity program, which provided numerous new opportunities for health education, cooking demonstrations, and health screening for the populations struggling with food insecurity. Marion Health is involved in workforce development and strengthening health education in our area. In 2025, Marion Health donated $100,000 to IVY Tech Community College for a state-of-the-art simulation lab for nursing and EMT students. Marion Health will assist students to apply for loan forgiveness though HRSA programs. To address our critical need for primary care physicians, Marion Health is currently in our second year of a Family Practice Residency program. Twenty-one colleges and universities are hosted with a robust program for student rotations and practicums in multiple areas of health care, providing student rotation hours. Nurses in the Parish Nurse Program provide preparation, education, and support for 128 faith community nurses and facilitate the Basic Parish Nurse Education Program (21 in person contact hours) each year. MH supports a community tobacco cessation specialist who is very involved in the area schools and not for profits organizations. Bridges to Health, a free health clinic, is primarily supported by donations from Marion Health to support staff and provide free or low-cost diagnostic care to Bridges patients who are under 300% of federal poverty level guidelines.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 7 State filing of community benefit report</FormAndLineReferenceDesc>
        <ExplanationTxt>IN</ExplanationTxt>
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          <BusinessNameLine1Txt>KATE'S KART</BusinessNameLine1Txt>
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          <AddressLine2Txt>SUITE A</AddressLine2Txt>
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        <ExplanationTxt>THE MARION HEALTH COMMUNITY SUPPORT POLICY/PROCEDURE PROVIDES GUIDANCE IN RESPONSE TO COMMUNITY ORGANIZATION REQUESTS FOR SUPPORT. AS ONE OF THE LARGER EMPLOYERS IN GRANT COUNTY, MARION HEALTH DEEMS IT BENEFICIAL AND NECESSARY TO BE A GOOD CORPORATE CITIZEN, AND WILL CONSIDER SUPPORT OF COMMUNITY ENDEAVORS AND PROJECTS THAT WILL IMPROVE THE LIVES AND LIVELIHOOD OF THE COMMUNITY IT SERVES.</ExplanationTxt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Cynthia Futrell</PersonNm>
        <TitleTxt>CNO</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Edmund Bendaly MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Charles Cossell DO</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <PersonNm>Kavita Raj DO</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <PersonNm>Daniel Edwards MD</PersonNm>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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          <BusinessNameLine1Txt>Indiana Finance Authority</BusinessNameLine1Txt>
        </IssuerName>
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      <TaxExemptBondsIssuesGrp>
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        <IssuerName>
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      <TaxExemptBondsIssuesGrp>
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        <IssuePriceAmt>18294415</IssuePriceAmt>
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      <TaxExemptBondsProceedsGrp>
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        <BondDefeasedAmt>0</BondDefeasedAmt>
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        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
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        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
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      <TaxExemptBondsProceedsGrp>
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        <BondDefeasedAmt>0</BondDefeasedAmt>
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        <InReserveFundAmt>0</InReserveFundAmt>
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        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>227415</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>0</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>18067000</OtherSpentProceedsAmt>
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        <SubstantialCompletionYr>2025</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
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      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>false</EngageBondCounselResearchInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
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        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>false</EngageBondCounselResearchInd>
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        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
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        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
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      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>false</EngageBondCounselResearchInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
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        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
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      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</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>true</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
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        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
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        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
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        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <TermOfGICPct>0</TermOfGICPct>
        <RegulatorySafeHarborStsfdInd>false</RegulatorySafeHarborStsfdInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
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        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</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>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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      <ProceduresCorrectiveActionGrp>
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        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column (f)</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 2020 BONDS WERE ISSUED TO FINANCE NEW MONEY PROJECTS OF MARION HEALTH. THE 2021 BONDS WERE ISSUED TO CURRENTLY REFUND THE 2012A BONDS, WHICH WERE ISSUED ON 04/26/2012, FOR PURPOSES OF (I) FINANCING THE ACQUISITION, CONSTRUCTION, EQUIPPING OR IMPROVEMENT OF CERTAIN CAPITAL ASSETS AND (II) REFUNDING THE ISSUER'S HOSPITAL REVENUE BONDS, SERIES 2002 (MARION GENERAL HOSPITAL PROJECT). THE 2025 BONDS WERE ISSUED TO CURRENTLY REFUND THE 2015A BONDS, WHICH WERE ISSUED ON 07/07/2015.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>TOTAL INVESTMENT EARNINGS FOR EACH ISSUE: 2020 BONDS - $2,463,337 2021 BONDS - $0 2025 BONDS - $0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part III, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>BECAUSE THE PRIVATE USE PERCENTAGE FOR EACH BOND ISSUE IS MONITORED TO ENSURE THAT THE PRIVATE USE LIMIT IS NOT EXCEEDED, THE AMOUNT OF PRIVATE PAYMENTS HAS NOT BEEN CALCULATED.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
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        </BusinessName>
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        <LoanPurposeTxt>RECRUITMENT</LoanPurposeTxt>
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        <BalanceDueAmt>42250</BalanceDueAmt>
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        <WrittenAgreementInd>true</WrittenAgreementInd>
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      <LoansBtwnOrgInterestedPrsnGrp>
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        <RelationshipWithOrgTxt>EMPLOYED</RelationshipWithOrgTxt>
        <LoanPurposeTxt>RECRUITMENT</LoanPurposeTxt>
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        <BalanceDueAmt>12500</BalanceDueAmt>
        <DefaultInd>false</DefaultInd>
        <BoardOrCommitteeApprovalInd>true</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>true</WrittenAgreementInd>
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      <LoansBtwnOrgInterestedPrsnGrp>
        <BusinessName>
          <BusinessNameLine1Txt>CHARLES E COSSELL DO</BusinessNameLine1Txt>
        </BusinessName>
        <RelationshipWithOrgTxt>EMPLOYED</RelationshipWithOrgTxt>
        <LoanPurposeTxt>RECRUITMENT</LoanPurposeTxt>
        <LoanFromOrganizationInd>X</LoanFromOrganizationInd>
        <OriginalPrincipalAmt>100000</OriginalPrincipalAmt>
        <BalanceDueAmt>24222</BalanceDueAmt>
        <DefaultInd>false</DefaultInd>
        <BoardOrCommitteeApprovalInd>true</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>true</WrittenAgreementInd>
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      <LoansBtwnOrgInterestedPrsnGrp>
        <BusinessName>
          <BusinessNameLine1Txt>SIRAJABID KHATIB MD</BusinessNameLine1Txt>
        </BusinessName>
        <RelationshipWithOrgTxt>EMPLOYED</RelationshipWithOrgTxt>
        <LoanPurposeTxt>RECRUITMENT</LoanPurposeTxt>
        <LoanFromOrganizationInd>X</LoanFromOrganizationInd>
        <OriginalPrincipalAmt>20000</OriginalPrincipalAmt>
        <BalanceDueAmt>12381</BalanceDueAmt>
        <DefaultInd>false</DefaultInd>
        <BoardOrCommitteeApprovalInd>true</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>true</WrittenAgreementInd>
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      <LoansBtwnOrgInterestedPrsnGrp>
        <BusinessName>
          <BusinessNameLine1Txt>DOUGLAS REX DO</BusinessNameLine1Txt>
        </BusinessName>
        <RelationshipWithOrgTxt>EMPLOYED</RelationshipWithOrgTxt>
        <LoanPurposeTxt>RECRUITMENT</LoanPurposeTxt>
        <LoanFromOrganizationInd>X</LoanFromOrganizationInd>
        <OriginalPrincipalAmt>20000</OriginalPrincipalAmt>
        <BalanceDueAmt>699</BalanceDueAmt>
        <DefaultInd>false</DefaultInd>
        <BoardOrCommitteeApprovalInd>true</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>true</WrittenAgreementInd>
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      <LoansBtwnOrgInterestedPrsnGrp>
        <BusinessName>
          <BusinessNameLine1Txt>STEPHEN KELLER MD</BusinessNameLine1Txt>
        </BusinessName>
        <RelationshipWithOrgTxt>EMPLOYED</RelationshipWithOrgTxt>
        <LoanPurposeTxt>RECRUITMENT</LoanPurposeTxt>
        <LoanFromOrganizationInd>X</LoanFromOrganizationInd>
        <OriginalPrincipalAmt>75000</OriginalPrincipalAmt>
        <BalanceDueAmt>63750</BalanceDueAmt>
        <DefaultInd>false</DefaultInd>
        <BoardOrCommitteeApprovalInd>true</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>true</WrittenAgreementInd>
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      <LoansBtwnOrgInterestedPrsnGrp>
        <BusinessName>
          <BusinessNameLine1Txt>CHARLES E COSSELL DO</BusinessNameLine1Txt>
        </BusinessName>
        <RelationshipWithOrgTxt>EMPLOYED</RelationshipWithOrgTxt>
        <LoanPurposeTxt>RECRUITMENT</LoanPurposeTxt>
        <LoanFromOrganizationInd>X</LoanFromOrganizationInd>
        <OriginalPrincipalAmt>25000</OriginalPrincipalAmt>
        <BalanceDueAmt>4167</BalanceDueAmt>
        <DefaultInd>false</DefaultInd>
        <BoardOrCommitteeApprovalInd>true</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>true</WrittenAgreementInd>
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      <TotalBalanceDueAmt>159969</TotalBalanceDueAmt>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>IMG INSURANCE</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE COMMENT</RelationshipDescriptionTxt>
        <TransactionAmt>747761</TransactionAmt>
        <TransactionDesc>SEE COMMENT</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule L, Part IV, Column (b)</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SON OF TIM DAILEY, MGH BOARD MEMBER, OWNS &gt;35% OF INSURANCE MANAGEMENT GROUP, A COMPANY WHICH CONDUCTS BUSINESS WITH MARION HEALTH.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="24020961" softwareVersionNum="2024v5.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4a-4c Description of program services</FormAndLineReferenceDesc>
        <ExplanationTxt>(Expenses $ 122,743,226 including grants of $ 365,524)(Revenue $ 133,703,562) MARION GENERAL HOSPITAL IS A NOT-FOR-PROFIT, 82-BED, ACUTE CARE, RURAL, SOLE COMMUNITY HOSPITAL LOCATED IN GRANT COUNTY, INDIANA. MGH PROVIDES HEALTHCARE SERVICES THROUGHOUT GRANT COUNTY (INCLUDES MARION, FAIRMOUNT, UPLAND, GAS CITY AND SWAYZEE) AND IN MIAMI COUNTY (CONVERSE), INDIANA. ADMINISTRATORS AND STAFF OF MARION GENERAL HOSPITAL BELIEVE EVERYONE SHOULD HAVE ACCESS TO HEALTHCARE AND CONTINUE TO ADDRESS ONGOING FINANCIAL CHALLENGES TO MEET THE HEALTHCARE NEEDS OF OUR COMMUNITY. CLIENTS AND FAMILIES RECEIVE IMPARTIAL ACCESS TO TREATMENT, AVAILABLE HEALTHCARE ACCOMMODATIONS AND MEDICALLY INDICATED SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR SOURCE OF PAYMENT FOR CARE. IN ADDITION TO THE INPATIENT SERVICES, RADIOLOGY SERVICES AND EMERGENCY ROOM SERVICES PREVIOUSLY DESCRIBED, MARION GENERAL HOSPITAL ALSO PROVIDES AMBULANCE, ANTICOAGULATION CLINIC, MEDICAL ONCOLOGY, CARDIOVASCULAR, CARDIAC CATH LAB, CHF CLINIC, CARDIAC REHAB, LABORATORY, OBSERVATION, NEURODIAGNOSTIC, SURGERY, PHYSICAL, SPEECH AND OCCUPATIONAL THERAPY, AND WOUND CLINIC SERVICES. MARION GENERAL HOSPITAL CONTINUES TO PROVIDE HOSPITALIST SERVICES 24/7, AS WELL AS INTERVENTIONAL CARDIOLOGY SERVICES PERFORMED BY ST. VINCENT MEDICAL GROUP PROVIDERS RIGHT HERE AT MARION GENERAL HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE ARE NORMALLY 15 MEMBERS OF THE BOARD, 13 OF WHICH ARE VOTING. THERE WAS ONE VACANCY AS OF JUNE 30, 2025, SO THERE WERE 14 MEMBERS OF WHICH 12 WERE VOTING MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1b</FormAndLineReferenceDesc>
        <ExplanationTxt>STEPHANIE HILTON-SIEBERT, DR. STEPHEN KELLER, DR. SHANKARAN SRIKANTH, DR. SIRAJABID KHATIB, AND DR. JAMES ORRELL ARE COMPENSATED AS EMPLOYEES OF THE ORGANIZATION. DR. M. NABI SHARIF IS COMPENSATED AS AN INDEPENDENT CONTRACTOR. AS A RESULT, ALL THE ABOVE INDIVIDUALS ARE CONSIDERED NON-INDEPENDENT BOARD MEMBERS. IN ADDITION, DR. SRIKANTH, DR. ORRELL, AND TIM DAILEY ARE ALSO CONSIDERED NON-INDEPENDENT DUE TO THE TRANSACTIONS LISTED ON SCH. L.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION INCORPORATES NUMEROUS PARTIES INTO THE PRODUCTION AND REVIEW OF THE FORM 990 AND ASSOCIATED SCHEDULES. FINANCE DEPARTMENT STAFF AND MANAGEMENT COMPLETE THE FORM 990 SCHEDULES. THE FORMS AND SCHEDULES ARE REVIEWED IN DETAIL BY THE ADMINISTRATIVE DIRECTOR OF FINANCE, CHIEF FINANCIAL OFFICER AND PRESIDENT/CEO. THE ORGANIZATION ENGAGES FORVIS LLP TO REVIEW THE COMPLETED FORM 990 AND ASSOCIATED SCHEDULES. PRIOR TO FILING THE RETURN, THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE 990, AND THE BOARD OF DIRECTORS ALSO RECEIVES A COPY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>EVERY YEAR EACH DIRECTOR, OFFICER AND MEMBER OF A COMMITTEE WITH BOARD OF DIRECTORS DELEGATED POWERS ARE REQUIRED TO SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, AGREES TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, A DETERMINATION IS MADE BY THE REMIANING BOARD OF DIRECTORS OR COMMITTEE MEMBERS IN ATTENDANCE AND WHO ARE ELIGIBLE TO VOTE. IF A CONFLICT DOES INDEED EXIST, THE PERSON IS REQUIRED TO LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE OF, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>TO SUPPORT THE MISSION, VISION, AND VALUES OF MARION GENERAL HOSPITAL, INC. (MARION HEALTH) AND THE CHARITABLE PURPOSE FOR WHICH IT EXISTS, THE EXECUTIVE TOTAL COMPENSATION PROGRAM IS DESIGNED AND ADMINISTERED TO ENSURE THAT MARION HEALTH CAN ATTRACT, RETAIN AND MOTIVATE HIGHLY TALENTED EXECUTIVES. EXECUTIVES ARE PLACED WITH APPROPRIATE SALARY RANGES BASED ON THE EXECUTIVE'S KNOWLEDGE, COMPETENCIES AND EXPERIENCE, PERFORMANCE, IMPORTANCE OF RETAINING THE EXECUTIVE, INTERNAL EQUITY CONSIDERATIONS AND FINANCIAL RESOURCES AVAILABLE. THE ORGANIZATION USES THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS TO REVIEW COMPENSATION PACKAGES, AND ALSO ENGAGES INDEPENDENT COMPENSATION CONSULTANTS TO PREPARE SURVEYS OR STUDIES TO ENSURE THAT THE EXECUTIVE TOTAL COMPENSATION IS REASONABLE AND COMPETITIVE. THIS PROCESS IS UNDERTAKEN ON AN ANNUAL BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b Process to establish compensation of other employees</FormAndLineReferenceDesc>
        <ExplanationTxt>HUMAN RESOURCES EVALUATES OTHER OFFICER AND SENIOR LEADERSHIP POSITION SALARIES WITH COMPARABLE DATA AVAILABLE FROM THE INDIANA HOSPITAL ASSOCIATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE KEPT ON SITE AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AS PART OF THE CONTINUING DISCLOSURES FOR THE MARION GENERAL HOSPITAL, INC. BONDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>PENSION RELATED CHANGES - -797412; NET PERIODIC PENSION COST - -1856412; GAIN(LOSS) ON JV - -333826; Total - -2987650;</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="24020961" softwareVersionNum="2024v5.1">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MGH FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>441 N WABASH AVENUE</AddressLine1Txt>
          <CityNm>MARION</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>46952</ZIPCd>
        </USAddress>
        <EIN>811872365</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MGH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PROGRESSIVE CANCER CARE LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>831 N THEATRE DRIVE</AddressLine1Txt>
          <CityNm>MARION</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>46952</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>ONCOLOGY CENTER</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IN</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>-261862</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>1976701</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.51061</OwnershipPct>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SHORT-TERM BOND LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 WEST MONROE</AddressLine1Txt>
          <CityNm>CHICAGO</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60603</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>FIXED INCOME INV</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DE</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MGH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Excluded</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>497036</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>11241085</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>1</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PROGRESSIVE CANCER CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>228549</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PROGRESSIVE CANCER CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>170005</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>