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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Leslie Wellman</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>001.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>7168371</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>1264267</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>606796</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>140</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Medical Solutions LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1010 N 102nd St Ste 300</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>681142122</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contracted Labor</ServicesDesc>
        <CompensationAmt>10139122</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Alliance Healthcare Services Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 735714</AddressLine1Txt>
            <CityNm>Dallas</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>753735714</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contracted Labor</ServicesDesc>
        <CompensationAmt>1504331</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Swope Construction</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1325 Bluefield Ave Suite 3A</AddressLine1Txt>
            <CityNm>Bluefield</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24701</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Construction Services</ServicesDesc>
        <CompensationAmt>847658</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>United Imaging Services LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>258021003</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contract Mobile Imaging</ServicesDesc>
        <CompensationAmt>793651</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Cepheid</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 74007537</AddressLine1Txt>
            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606747537</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Molecular Lab Testing</ServicesDesc>
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      <TotalContributionsAmt>26180</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>278343546</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>278343546</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>459865</RelatedOrExemptFuncIncomeAmt>
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        <ExclusionAmt>4545325</ExclusionAmt>
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      <NetRentalIncomeOrLossGrp>
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      <LessCostOthBasisSalesExpnssGrp>
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      <NetGainOrLossInvestmentsGrp>
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        <ExclusionAmt>-329827</ExclusionAmt>
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        <BusinessCd>722514</BusinessCd>
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        <ExclusionAmt>1109734</ExclusionAmt>
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      <OtherRevenueMiscGrp>
        <Desc>Contracted Services</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>426569</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueMiscGrp>
        <Desc>Linen Services</Desc>
        <BusinessCd>812300</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>358670</RelatedOrExemptFuncIncomeAmt>
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      <MiscellaneousRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>208651</RelatedOrExemptFuncIncomeAmt>
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      <TotalRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>279580195</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>5482792</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>85000</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>11522</TotalAmt>
        <ProgramServicesAmt>11522</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
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      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
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      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>3094145</TotalAmt>
        <ProgramServicesAmt>1822890</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1271255</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
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      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>83624487</TotalAmt>
        <ProgramServicesAmt>77579582</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6044905</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>2445236</ProgramServicesAmt>
        <ManagementAndGeneralAmt>161592</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
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        <ProgramServicesAmt>19747717</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1486714</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>6218179</TotalAmt>
        <ProgramServicesAmt>5768690</ProgramServicesAmt>
        <ManagementAndGeneralAmt>449489</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>481661</TotalAmt>
        <ProgramServicesAmt>15599</ProgramServicesAmt>
        <ManagementAndGeneralAmt>466062</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>97469</TotalAmt>
        <ManagementAndGeneralAmt>97469</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>42591</TotalAmt>
        <ProgramServicesAmt>42591</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising></FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
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        <ProgramServicesAmt>41260935</ProgramServicesAmt>
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      <AdvertisingGrp>
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        <ProgramServicesAmt>2608</ProgramServicesAmt>
        <ManagementAndGeneralAmt>691694</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
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        <ProgramServicesAmt>6826273</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3255235</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
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        <ProgramServicesAmt>331479</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1550458</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
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      <OccupancyGrp>
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        <ProgramServicesAmt>2710100</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1334101</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>258836</ProgramServicesAmt>
        <ManagementAndGeneralAmt>135370</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
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      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
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        <ProgramServicesAmt>1910173</ProgramServicesAmt>
        <ManagementAndGeneralAmt>939716</ManagementAndGeneralAmt>
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      <PaymentsToAffiliatesGrp>
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        <ProgramServicesAmt>4722103</ProgramServicesAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>929045</ProgramServicesAmt>
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      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
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        <ProgramServicesAmt>44709715</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Provision for Doubtful Accounts</Desc>
        <TotalAmt>15166281</TotalAmt>
        <ProgramServicesAmt>15166281</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Taxes, Licenses and Fees</Desc>
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        <ProgramServicesAmt>7950054</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1509440</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Recruiting</Desc>
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        <ProgramServicesAmt>1088880</ProgramServicesAmt>
        <ManagementAndGeneralAmt>703833</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
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        <ProgramServicesAmt>52483</ProgramServicesAmt>
        <ManagementAndGeneralAmt>489210</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>242082761</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49044153</ManagementAndGeneralAmt>
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      <CashNonInterestBearingGrp>
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      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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      <AccountsReceivableGrp>
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      <InventoriesForSaleOrUseGrp>
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      <PrepaidExpensesDefrdChargesGrp>
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      <DeferredRevenueGrp>
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      <MortgNotesPyblScrdInvstPropGrp>
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      <OtherLiabilitiesGrp>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>150078527</EOYAmt>
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      <NoDonorRestrictionNetAssetsGrp>
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      <TotalNetAssetsFundBalanceGrp>
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        <EOYAmt>15681933</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>165760460</EOYAmt>
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      <OtherChangesInNetAssetsAmt>22624064</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
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      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
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      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>true</DirectContactLegislatorsInd>
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      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
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      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>II-B 1i</FormAndLineReferenceDesc>
        <ExplanationTxt>This amount is calculated based on information provided by the West Virginia Hospital Association and the American Hospital Association. The American Hospital Association estimates that 32 of the 2023 dues were allocated to lobbying expense. The West Virginia Hospital Association estimates that during 2023, 12.04 of the dues paid should be allocated to lobbying expense.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>II-B 1g</FormAndLineReferenceDesc>
        <ExplanationTxt>The President of Princeton Community Hospital Association as part of her duties, monitors legislation that may potentially affect Princeton Community Hospital Association and voices her support or concerns regarding that legislation to legislators either in person, by phone, or by mail .Princeton Community Hospital Association does not participate in or intervene in including publishing or distributing of statements any political campaign on behalf of or in opposition to any candidate for public office.</ExplanationTxt>
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        <BookValueAmt>1804613</BookValueAmt>
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        <BookValueAmt>13340544</BookValueAmt>
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        <BookValueAmt>6881728</BookValueAmt>
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      <OtherSecuritiesGrp>
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      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Closely-held equity interests</Desc>
      </OtherSecuritiesGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Federal income taxes</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Long Term Lease Liability</Desc>
        <Amt>489228</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Capitalized Leases Payable - Non Current</Desc>
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      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DB Pension Obligation</Desc>
        <Amt>60502144</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>62511017</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
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      <NetUnrealizedGainsInvstAmt>-904384</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>-17098156</OtherRevenueAmt>
      <RevenueNotReportedAmt>-18002540</RevenueNotReportedAmt>
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      <OtherRevenuesNotIncludedAmt>4287</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>4287</RevenueNotReportedFinclStmtAmt>
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      <TotExpnsEtcAuditedFinclStmtAmt>274050602</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>21844</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>21844</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>274028758</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>17098156</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>17098156</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>291126914</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>X 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Most of the entities that comprise the System are tax-exempt organizations and not subject to federal or state income taxes in accordance with Section 501c3 of the Internal Revenue Code. On such basis, they will not incur any liability for income taxes, except for possible unrelated business income. AHS, BCHS, PHIC, HPN, and TMHS are organizations subject to federal and/or state income taxes. The System does not have any material uncertain tax positions as of December 31, 2023 and 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XI 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>This amount shown on line 2d consists of 15,166,281 Provision for Doubtful Accounts - Patients and 1,931,875 defined benefit reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XI 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount shown on line 4b consists of 21,844 expenses associated with the properties for which rental income is received and presented as an offset to revenue on the 990 and 26,131 contributions from the Foundation that are posted to Net Assets on the financials.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount shown on line 2d consists 21,844 of expenses associated with the properties for which rental income is received and reported in Part VII line 6b.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount shown on line 4b consists of 15,166,281 Provision for Doubtful Accounts - Patients and 1,931,875 defined benefit reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="990H" softwareId="23017659" softwareVersionNum="23.1.0.0">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>false</FPGReferenceDiscountedCareInd>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>true</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>false</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>616573</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>616573</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00220</TotalExpensePct>
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      <UnreimbursedMedicaidGrp>
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        <DirectOffsettingRevenueAmt>74765269</DirectOffsettingRevenueAmt>
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      <UnreimbursedCostsGrp>
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      <CashAndInKindContributionsGrp>
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      <TotalOtherBenefitsGrp>
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      <MedicareSurplusOrShortfallAmt>2550827</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
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        <BusinessName>
          <BusinessNameLine1Txt>Princeton Community Hospital Association</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>122 Twelfth Street</AddressLine1Txt>
          <CityNm>Princeton</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>24740</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>https//wvumedicine.org/princeton/</WebsiteAddressTxt>
        <StateLicenseNum>104</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
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        <TaxExemptHospitalCYOrPYInd>true</TaxExemptHospitalCYOrPYInd>
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        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
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        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>false</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>https//wvumedicine.org/wp-content/uploads/2024/08/Princeton-Community-Hospitalcommunityhealthneedsas</OwnWebsiteURLTxt>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>22</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>https//wvumedicine.org/wp-content/uploads/2024/08/Princeton-Community-Hospitalcommunityhealthimpleme</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
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        <FPGFamilyIncmLmtFreeCarePct>0000000200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>https//wvumedicine.org/bill-pay/financial-assistance/</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>https//wvumedicine.org/wp-content/uploads/2022/10/WVUHFAP-Financial-Application1020202.pdf</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>https//wvumedicine.org/bill-pay/financial-assistance/</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <ProspectiveMedicareMedicaidInd>X</ProspectiveMedicareMedicaidInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>true</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Princeton Community Hospital Association Line Part V, Section B, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Effective January 1, 2023, Princeton Community Hospital Association became a member of the West Virginia United Health System. Prior to becoming a part of the West Virginia United Health System, Princeton Community Hospital Association was operated under the local county government.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Princeton Community Hospital Association Line Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The following organizations provided thorough input throughout the process of developing the CHNA. These individuals formed the public input survey and were instrumental in dissemination. Additionally, they identified and invited attendees of the focus group, and were charged as a group with collaborative discussion of primary and secondary data to determine health priorities. This team included Princeton Community Hospital Association leadership, Sacred Heart Princeton, Sacred Heart Bluefield, Lifeline Church Princeton, Lifeline Church Hinton, Lifeline Church Peterstown, and Lifeline Church Christiansburg, VA. Pastor JB Hurt and Fr. Sebastian Devasya were asked to speak to the experiences of the populations whom they serve or represent.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Princeton Community Hospital Association Line Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>The list of top health concerns were organized into four categories and will be the focus moving forward with implementation planning. These four categories are Substance Use and Mental Health, Obesity and Diabetes, Cancer, and Cardiovascular Health. Princeton Community Hospital Association PCH plans to continue their partnership with The Behavioral Health Pavilion of the Virginias. The Pavilion provides mental health and substance use services to the local community. In addition to this partnership, PCH plans to participate in Out of the Darkness Walk, provide mental health education and screenings to area colleges, nursing homes, businesses, and other community organizations, and provide education via radio talk shows throughout the year on various mental health topics. Diabetes education classes will be offered annually on an as-needed basis based on referrals from physicians. PCH recently opened its cardiac clinic. This clinic will focus on clinical outcomes related to cardiovascular health. The cardiac clinic staff has focused on in-house education for patients and is hoping to expand to more community-wide education in the future. The cardiac clinic is an opportunity to not only expand clinical services and access to care for the local community, but is a way to encourage patients and community members to engage with education on other health topics such as obesity or diabetes. PCH offers one on one support to cancer patients as well as free educational materials. PCH also hosts 1-2 cologuard screening events yearly. Lastly, PCH has a cancer care program that supports cancer patients by providing funds for medication, co-pays, home equipment, nutritional supplements, and travel to and from appointments. Part of this program also helps patients receive wigs, hats, or scarves should they need them.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Princeton Community Hospital Association Line Part V, Section B, Line 13b</FormAndLineReferenceDesc>
        <ExplanationTxt>Princeton Community Hospital Association PCH offers discounted care only to individuals who qualify for free care. PCH offers a Prompt-Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 50 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible for either prompt pay discount, the patient/guarantor must meet certain requirements.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Princeton Community Hospital Association Line Part V, Section B, Line 24</FormAndLineReferenceDesc>
        <ExplanationTxt>All patients are charged an amount equal to gross charges regardless of payment method. Once FAP eligibility is confirmed, charge amounts are moved to Charity Care and no longer charged to the patient.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>18</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PCH Bluefield ED and Ancillary Services</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>500 Cherry Street</AddressLine1Txt>
            <CityNm>Bluefield</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>247013306</ZIPCd>
          </USAddress>
          <FacilityTxt>Emergency Services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Mercer Medical Group Primary Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>118 12th Street Ext</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24740</ZIPCd>
          </USAddress>
          <FacilityTxt>Primary Care</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MMG General Surgery</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>201 12th Street Ext</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>247402329</ZIPCd>
          </USAddress>
          <FacilityTxt>Surgery Services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Bluefield Cardiology &amp; Internal Medicine</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>510 Cherry Street Building A</AddressLine1Txt>
            <CityNm>Bluefield</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24701</ZIPCd>
          </USAddress>
          <FacilityTxt>Cardiology and Internal Medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Mercer Medical Group</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>122 12th Street Ext Suite A</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24740</ZIPCd>
          </USAddress>
          <FacilityTxt>ENT and Oncology</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Mercer Medical Group</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>508 New Hope Road Suite 7</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>247402265</ZIPCd>
          </USAddress>
          <FacilityTxt>Cardiology, Nephrology, Neurology</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Blue Ridge Internal Medicine</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>407 12th Street Ext</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24740</ZIPCd>
          </USAddress>
          <FacilityTxt>Internal Medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Mercer Medical Group Urology</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>296 New Hope Road Bldg 2 Suite 2</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24740</ZIPCd>
          </USAddress>
          <FacilityTxt>Urology</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Mercer Medical Group Womens Health</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>150 Courthouse Road</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24740</ZIPCd>
          </USAddress>
          <FacilityTxt>OB/GYN</FacilityTxt>
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          <BusinessName>
            <BusinessNameLine1Txt>Bluefield Surgical Services</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>150 Courthouse Road</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24740</ZIPCd>
          </USAddress>
          <FacilityTxt>Surgery Services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Bluewell Family Medicine</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>154 Majestic Place</AddressLine1Txt>
            <CityNm>Bluefield</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24701</ZIPCd>
          </USAddress>
          <FacilityTxt>Family Medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Bluefield Family Medicine</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>106 Huffard Drive</AddressLine1Txt>
            <CityNm>Bluefield</CityNm>
            <StateAbbreviationCd>VA</StateAbbreviationCd>
            <ZIPCd>24602</ZIPCd>
          </USAddress>
          <FacilityTxt>Family Medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Athens Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>401 Vermillion Street</AddressLine1Txt>
            <CityNm>Athens</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24712</ZIPCd>
          </USAddress>
          <FacilityTxt>Family Medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Hematology Oncology Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>118 Undercliff Terrace</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24740</ZIPCd>
          </USAddress>
          <FacilityTxt>Oncology</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Mercer Medical Group Pediatrics</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>114 Undercliff Terrace</AddressLine1Txt>
            <CityNm>Princeton</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24740</ZIPCd>
          </USAddress>
          <FacilityTxt>Pediatrics</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Rural Imaging Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>930 Cook Parkway</AddressLine1Txt>
            <CityNm>Oceana</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24870</ZIPCd>
          </USAddress>
          <FacilityTxt>Imaging</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Rural Imaging Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>205 Howard Avenue</AddressLine1Txt>
            <CityNm>Mullens</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25882</ZIPCd>
          </USAddress>
          <FacilityTxt>Imaging</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Rural Imaging Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>19693 Coal Heritage Road</AddressLine1Txt>
            <CityNm>Welch</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>24801</ZIPCd>
          </USAddress>
          <FacilityTxt>Imaging</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3c</FormAndLineReferenceDesc>
        <ExplanationTxt>Princeton Community Hospital Association PCH uses 200 Federal Poverty Guideline to determine free care eligibility. PCH offers a Prompt - Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 50 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible for either discount the patient/guarantor must meet certain requirements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Princeton Community Hospital Association community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The most recent amounts can be found at the following web address http//wvumedicine.org/about/leadership-and-more/community-benefit/.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Column f - Net community benefit expense for 2023 is 717,104 and is 0.26 of total net expenses. To calculate net expense, Provision for Doubtful Accounts - Patients of 15,166,281 was deducted from total expenses of 291,126,914 as shown in Part IX line 25 of the core Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Worksheet 2 from the IRS Schedule H instructions was used to derive the Cost-to-charge ratio, which was used to calculate Charity Care, Unreimbursed Medicaid and other means-tested government programs at cost. To calculate the Medicare allowable cost shown in Part III question 8, we used the allowable costs from the Medicare Cost report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debt Expense at Cost on Line 2 was calculated by multiplying Provision for Doubtful Accounts - Patients expense of 15,166,281 by our cost-to-charge ratio of 31.95 for a total of 4,845,627.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Estimated bad debt attributable to patients eligible for charity care on Line 3 was calculated by pulling all outstanding patient balances of 25,000 or greater from our patient accounting system. That report totaled 540,867, which was then multiplied by the cost-to-charge ratio of 31.95 for a total of 172,807.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>We feel that at a minimum, the estimated bad debt attributable to patients eligible for charity care of 172,807 should be considered community benefit due to the fact that anyone with outstanding balances of 25,000 or greater in our demographic usually qualifies as catastrophic if the patient completes the application process. In our Charity Care Policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year and would have qualified for charity care if paperwork was completed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Patient accounts receivables are primarily paid by federal and state governmental authorities under the Medicare and Medicaid programs, managed health plans, commercial insurance companies, workers compensation programs, employers and patients. Patient accounts receivable are reported at net realizable value. For accounts receivable associated with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions. The System does not believe there are any significant concentrations of revenues from any particular payor that would subject the System to any significant credit risks in the collection of patient accounts receivable. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters. Changes in general economic conditions, patient accounting service center operations, payor mix, payor claim processing could affect collections of accounts receivable, cash flows and results of operations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The System performs periodic assessments to determine if an allowance for expected credit losses is necessary. The System considers its incurred loss experience and adjusts for known and expected events and other circumstances. In estimating its expected credit losses, the System may consider changes in the length of time its receivables have been outstanding, changes in credit ratings for payors, requests from payors to alter payment terms due to financial difficulty, and notices of payor bankruptcies or payors entering receivership. Because the Systems accounts receivable is typically paid for by highly solvent, creditworthy payors, such as Medicare, Medicaid, other governmental programs, and highly regulated commercial insurers on behalf of the patient, the Systems credit losses are immaterial to the consolidated financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The mix of accounts receivable at December 31, 2023 and 2022, from patients and third-party payors is as follows For the year-end December 31, 2023 Medicare - 25, Medicaid - 13, Blue Cross - 21, Commercial, managed care and other - 39, Patients - 2, totaling 100. For the year-end December 31, 2022 Medicare - 27, Medicaid - 16, Blue Cross - 19, Commercial, managed care and other - 35, Patients - 3, totaling 100.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount reported in Part III Line 6 108,891,135 was calculated using the total Medicare allowable cost from the Medicare cost report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>PCH does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity care, the patient will not be sent to a bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The 2022 CHNA process began with a thorough review of the previous cycles needs assessment report, and included review of publicly available secondary data related to counties within PCHs service area. This information included census data and County Health Rankings Data. Using these reports as a springboard, the leadership team started the initial discussion around critical health needs, changes in the community demographics over the previous few years, and lessons learned from the last CHNA cycles health topic prioritization and development of implementation activities.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Primary data collection was comprised of surveying community members to gather perceptions of health issues, access to care, qualify of life, and other related topics. This data was supplemented by a focus group. A meeting was then held to focus on reviewing the survey data, discuss community assets that impact population health in PCHs service area, as well as discuss the needs of those not well-represented in the survey data. At this meeting, the group worked to discuss possible strategies for each area of concern, as well as existing resources to address these needs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Charity care eligibility guidelines are listed on our website at https//wvumedicine.org/bill-pay/financial-assistance/.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>PCH is a non-profit critical access hospital located in Mercer County, WV . In 2023, Mercer County had a total population of 58,057, a median household income of 46,409, an employment rate of 59.7 and 7.9 of residents reported they were without healthcare coverage. Approximately 21.2 of residents were living in poverty. Other communities served by PCH include McDowell, Monroe, Summers, and Wyoming counties. McDowell county had a population of 17,439, a median household income of 28,235, an employment rate of 25.2 and 10.4 of residents reported they are without healthcare coverage. Approximately 37.6 of residents were living in poverty. Monroe county had a population of 12,382, a median household income of 52,392, an employment rate of 50.6 and 8.1 of residents reported thay are without healthcare. Approximately 15.0 were living in poverty. Summers county had a population of 11,581, a median household income of 42,991, an employment rate of 37.3 and 8.3 of residents reported they are without healthcare. Approximately 23.1 were living in poverty. Wyoming county had a population of 20,277, a median household income of 44,510, an employment rate of 37.3 and 9.2 of residents reported they are without healthcare. Approximately 25.3 were living in poverty. Population and demographic info was obtained from United States Census Bureau http//data.census.gov/cedsci/.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Princeton Community Hospital Association participates in various community events and meetings including the following the Christmas Parade, Rotary Club of Princeton events, Princeton Rescue Squad events, VA Lions Club events, Mercer County Local Emergency Planning Committee, Princeton Economic Development Committee, Mercer County Advisory Board, and WV Healthcare Coalition meetings. The President of PCH also participates in the local SHRM chapter.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Princeton Community Hospital is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional health care delivery system in its service areas, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include West Virginia University Hospitals, Inc. in Morgantown, WV, United Hospital Center in Bridgeport, WV, Camden-Clark Memorial Hospital in Parkersburg, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Potomac Valley Hospital in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, West Virginia Healthcare Cooperative, doing business as, Summersville Regional Medical Center in Summersville, WV, Braxton County Memorial Hospital in Gassaway, WV, Community Health Association, doing business as, Jackson General Hospital in Ripley, WV, Reynolds Memorial Hospital in Glen Dale, WV, Barnesville Hospital Association in Barnesville, OH, Uniontown Hospital in Uniontown, PA, Wheeling Hospital, Inc. in Wheeling, WV, Harrison Community Hospital, Inc. in Cadiz, OH, GRMC, Inc. in Oakland, MD, Princeton Community Hospital Association, Inc. in Princeton, WV, Thomas Health System, Inc. in South Charleston, WV, and Grant Memorial Hospital, Inc. in Petersburg, WV.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>In addition to the above mentioned hospitals, the System includes physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, Inc. a behavioral health center located in Clarksburg, WV. The System also includes, WVUH-East, Inc. and Camden-Clark Health Services, Inc. which operate as management companies for their respective hospitals. University Healthcare Foundation, Inc. in Martinsburg, WV, United Health Foundation, Inc. in Bridgeport, WV, Camden-Clark Foundation, Inc. in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, Inc. in Glen Dale, WV, which perform various fundraising activities for their respective hospitals. In 2020, the System formed WVUHS Home Care, LLC to provide Home Health and Hospice services to our service areas, supporting System hospitals by providing continuous care to our patients. Wheeling Hospital Ambulatory Surgical Center, LLC a surgical center located in Bridgeport, OH was acquired in 2021.</ExplanationTxt>
      </SupplementalInformationDetail>
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          <BusinessNameLine1Txt>Princeton Rescue Squad</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>701 Stafford Drive</AddressLine1Txt>
          <CityNm>Princeton</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>24740</ZIPCd>
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        <PurposeOfGrantTxt>Donation for Education Center</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>City of Princeton WV</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>800 Bee Street</AddressLine1Txt>
          <CityNm>Princeton</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>24740</ZIPCd>
        </USAddress>
        <RecipientEIN>556000237</RecipientEIN>
        <CashGrantAmt>5000</CashGrantAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>Donation for ADA Playground at City Park</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <TotalOtherOrgCnt>1</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Scholarships</GrantTypeTxt>
        <RecipientCnt>5</RecipientCnt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I</FormAndLineReferenceDesc>
        <ExplanationTxt>Princeton Community Hospital Association does not track the use of funds once they are donated, however contributions made are in alignment with the overall mission of the hospital.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <PersonNm>Amos Lane</PersonNm>
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        <PersonNm>Karen Bowling</PersonNm>
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        <PersonNm>Thomas Martin</PersonNm>
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        <PersonNm>Mark Weitzel</PersonNm>
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        <PersonNm>Stephen Ward</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation for the CEO is determined by the WV United Health System compensation committee. The System engages an independent group to perform an executive compensation review and compensation survey every two years. This information is provided to the committee, which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package offered does not exceed fair market value.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Tom Takubo received deferred compensation contributions of 86,063 in 2023 from related party. This amount is properly recorded in deferred compensation on the Form 990 Schedule J.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Karen Bowling received direct cash payments instead of deferral of income. She received cash distributions of 87,832</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Per the WVUHS Incentive Plan incentives are contingent on meeting a net earning target.</ExplanationTxt>
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    </IRS990ScheduleJ>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d</FormAndLineReferenceDesc>
        <ExplanationTxt>Program Service Expenses 180,258,770, Grants and allocations 0, Revenue 208,179,970 We recognize that as our community continues to grow, so does our responsibility to keep its citizens healthy. With that goal in mind, we have made continual advancements that benefit our patients every day. We are a regional leader in joint replacement and have invested well over 1 million in minimally invasive surgery and joint replacement technology. We have tripled the capacity of our Day Surgery department. We have also added our Womens Center which offers family-friendly birthing suites, secure nurseries, and a private setting for womens diagnostic services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Other changes in net assets includes 9,169,627 of related organization capitalization, 5,845,138 of pension adjustment, 275,500 of JOA contribution to SOM, 36,849,185 of donated capital, 26,131 contributions from the Foundation, and 74,789,642 of beginning net assets. Prior to joining the West Virginia United Health System, Princeton Community Hospital Association was operated as a branch of a gevernemental entity. As such they were exempted from filing Form 990. The 74,789,642 of beginning net asssets are the restults of operations prior to January 1, 2023.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Other service expenses consist of the following items Consulting Professional Fees of 7,052,941 of which 3,530,697 is considered program service and 3,522,244 is considered management and general Contract Labor/Purchased Service of 44,829,812 of which 37,499,887 is considered program service and 7,329,925 is considered management and general Physician Income Guarentees of 205,024 of which all is considered management and general Resident Expense of 8,150 of which all is considered management and general and Collection Fees of 232,993 of which 230,351 is considered program service and 2,642 is considered management and general.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Upon employment and annually thereafter, each key employee and officer of the organization is required to complete a conflict of interest and disclosure form, providing sufficient information about his/her personal interests and relationships so the organization can 1 determine whether any potential or actual conflicts of interest may exist, and 2 monitor work or service assignments to avoid placing the key employee, officer, or director in a position where there may be an appearance potential or actual of a conflict of interest or a question of objectivity. The completed conflict of interest and disclosure forms for directors are returned to the organization. These members are monitored and not assigned any projects that would create any potential conflict of interest. Any board member with a potential conflict recuses himself or herself from all discussions regarding the conflict.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the CEO is determined by the WV United Health System Compensation Committee based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This information is provided to the compensation committee which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package does not exceed fair market value based on the data from the consultant group. The minutes of the compensation committee are contemporaneously documented and retained. A full compensation survey was completed in 2022 for 2023 compensation amounts.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of all officers at the Vice President level and below is determined based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This data is then interpreted and provided to an independent compensation committee. The independent compensation committee then uses this data to determine a fair and reasonable compensation package. All relevant data as well as minutes from each meeting are retained.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All financial and governing documents, including the conflict of interest policy are maintained onsite and made available to the public upon written request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>West Virginia United Health System, Inc., a 501c3 charitable organization WVUHS, is the sole member of the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>In 2023, West Virginia United Health System WVUHS, EIN 55-0754713, transitioned to a centralized accounts payable process in which WVUHS made the majority of vendor payments and then issued the required 1099s. WVUHS is reimbursed by the entities for their portion of payments made, vendor payments that meet the Top 5 Independent Contractor reporting requirements are reported in Part VII, Section B of the reporting entity.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Effective January 1, 2023, West Virginia United Health System WVUHS became the sole member of Princeton Community Hospital Assocaition, Inc.. WVUHS is a West Virginia nonprofit organization and an organization exempt from federal income tax persuant to Section 501c3 of the Code.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>The power of the sole Member shall be all of those permitted by the general corporate laws of the State of West Virginia, including, without limitations, the following powers reserved unto the Member over the Corporation which include removal of any member or members of the governing board.</ExplanationTxt>
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      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>