<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2021v4.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-05-15T07:49:47-05:00</ReturnTs>
    <TaxPeriodEndDt>2022-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>390859910</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>BAKER TILLY US LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1570 FRUITVILLE PIKE SUITE 400</AddressLine1Txt>
        <CityNm>LANCASTER</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>17601</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2021-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>510426500</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MOUNT NITTANY MEDICAL CENTER HEALTH</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>SERVICES INC</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>MOUN</BusinessNameControlTxt>
      <PhoneNum>8142317000</PhoneNum>
      <USAddress>
        <AddressLine1Txt>1800 EAST PARK AVENUE</AddressLine1Txt>
        <CityNm>STATE COLLEGE</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>16803</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>BRYAN ROACH</PersonNm>
      <PersonTitleTxt>SENIOR EXECUTIVE VP &amp; CFO</PersonTitleTxt>
      <PhoneNum>8142317000</PhoneNum>
      <SignatureDt>2023-05-10</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>BRYAN</PersonFirstNm>
        <PersonLastNm>ROACH</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>KERRI N BOGDA CPA</PreparerPersonNm>
      <PTIN>P00760402</PTIN>
      <PhoneNum>7177404863</PhoneNum>
      <SelfEmployedInd>X</SelfEmployedInd>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2021</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>MOUNT NITTANY PHYSICIAN GROUP</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>KATHLEEN RHINE</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>1800 EAST PARK AVENUE</AddressLine1Txt>
        <CityNm>STATE COLLEGE</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>16803</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>71237531</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.MOUNTNITTANY.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2002</FormationYr>
      <LegalDomicileStateCd>PA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>DEVELOP AND PROVIDE PROFESSIONAL SERVICES TO SUPPORT THE MISSION OF MOUNT NITTANY HEALTH SYSTEM.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>6</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>1</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>579</TotalEmployeeCnt>
      <TotalVolunteersCnt>1</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>58967828</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>186751</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>57654502</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>63768598</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1699</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>36478</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>5403039</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>6572627</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>122027068</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>70564454</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>6840697</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>62952415</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>71598172</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>24477020</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>30976883</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>87429435</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>109415752</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>34597633</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-38851298</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>76955492</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>34744736</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>27262615</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>23903157</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>49692877</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>10841579</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>MNMC HEALTH SERVICES, INC. IS ORGANIZED TO DEVELOP PROFESSIONAL SERVICES TO SUPPORT THE VISION OF MOUNT NITTANY HEALTH SYSTEM, WHICH SERVES THE CENTER REGION OF PENNSYLVANIA BY PROVIDING ACUTE CARE HOSPITAL SERVICES AND MULTI-SPECIALTY PROFESSIONAL SERVICES.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>93394327</ExpenseAmt>
      <GrantAmt>6840697</GrantAmt>
      <RevenueAmt>67961729</RevenueAmt>
      <Desc>MNMC HEALTH SERVICES INC. IS AN AFFILIATE OF MOUNT NITTANY HEALTH SYSTEM (HEALTH SYSTEM) WHICH INCLUDES AN ACUTE CARE HOSPITAL (MOUNT NITTANY MEDICAL CENTER), MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES, INC., CENTRE COUNTY CHILDREN'S ADVOCACY CENTER, AND THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER, INC. THE HEALTH SYSTEM IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO COORDINATE AND MANAGE THE INTEGRATION OF THE DELIVERY OF HEALTHCARE SERVICES AND PERFORM ACTIVITIES THAT BENEFIT ITS AFFILIATES. CONTINUED ON SCHEDULE O.MNMC HEALTH SERVICES INC. WAS CREATED TO PROVIDE CHARITABLE, SCIENTIFIC, AND EDUCATIONAL SERVICES AS DETERMINED BY THE CORPORATION'S BOARD OF DIRECTORS, BUT SUBJECT TO ANY RIGHTS AND POWERS THAT ARE RESERVED TO MOUNT NITTANY HEALTH SYSTEM TO EMPLOY AND CONTRACT WITH PHYSICIANS IN ORDER TO SUPPORT MOUNT NITTANY MEDICAL CENTER, FOR THE CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES IN ITS COORDINATION AND DELIVERY OF HEALTH CARE SERVICES TO THE COMMUNITY.MNMC HEALTH SERVICES, INC. SUPPORTS THE HEALTH SYSTEM BY EMPLOYING APPROXIMATELY 98 PHYSICIANS WHO PROVIDE A VARIETY OF PRIMARY AND SPECIALTY CARE SERVICES AT A GROWING NUMBER OF OFFICES THROUGHOUT CENTRAL PENNSYLVANIA. OUR STAFF IS BOARD-CERTIFIED OR BOARD ELIGIBLE AND GROWING, AND WE PRIDE OURSELVES IN WORKING WITH AREA PROVIDERS TO MAXIMIZE HEALTHCARE OPPORTUNITIES FOR THE PEOPLE OF THIS REGION.ONE OF MOUNT NITTANY HEALTH SYSTEM'S MAJOR GOALS IN FORMING THE MNMC HEALTH SERVICES INC. WAS TO PROVIDE QUALITY CARE AT CONVENIENT LOCATIONS IN CENTRAL PENNSYLVANIA - NOT JUST PRIMARY CARE, BUT CARE IN MORE THAN 20 ADVANCED SPECIALTY AREAS.CHARGES FOR SERVICES PROVIDED WERE COMPRISED OF:- 42.3% MEDICARE- 7.6% MEDICAID- 1.6% SELF-PAY - 48.5% OTHERMNMC HEALTH SERVICES PROVIDES PHYSICIAN HEALTH CARE SERVICES FOR RESIDENTS OF ITS PRIMARY SERVICE AREA, WHICH INCLUDES STATE COLLEGE AND SURROUNDING COMMUNITIES. CHARITY CARE WAS $305,342 FOR FYE 2022.</Desc>
      <TotalProgramServiceExpensesAmt>93394327</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">0</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">1</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>12</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>579</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>6</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>1</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>PA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>BRYAN ROACH SENIOR EXECUTIVE VP &amp; CFO</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>8142317000</PhoneNum>
        <USAddress>
          <AddressLine1Txt>1800 EAST PARK AVENUE</AddressLine1Txt>
          <CityNm>STATE COLLEGE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16803</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>EMILY PETERSON MD</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>595522</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30614</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTOPHER YINGLING MD</PersonNm>
        <TitleTxt>SECRETARY/TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>611257</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32387</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHLEEN RHINE</PersonNm>
        <TitleTxt>PRESIDENT/CHIEF EXECUTIVE OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>38.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1099599</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>134367</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFFREY PRO MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>38.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>375304</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30614</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BILL JOSEPH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>R KEVIN MURRAY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRYAN ROACH</PersonNm>
        <TitleTxt>EXECUTIVE VP &amp; CFO</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>38.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>599631</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>49022</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES PROWANT</PersonNm>
        <TitleTxt>CHIEF OPERATING OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>364331</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26039</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTOPHER HESTER MD</PersonNm>
        <TitleTxt>PRIMARY CARE CHIEF</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>399308</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29914</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES LEIB DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>861330</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21218</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VEERAL PATEL MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>837551</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35739</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES MARTIN MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>829113</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29929</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN SPENCER DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>820366</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24712</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHEN PHILLIPS DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>751040</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17126</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LANCE ROSE</PersonNm>
        <TitleTxt>FORMER CEO/OFFICER/DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>14721</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>6445122</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>1713951</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>461681</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>137</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WEATHERBY LOCUMS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 972633</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75397</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TEMPORARY PROVIDERS</ServicesDesc>
        <CompensationAmt>386195</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>COMPHEALTH MEDICAL STAFF</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 972670</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75397</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TEMPORARY PROVIDERS</ServicesDesc>
        <CompensationAmt>304218</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TEGRIA SERVICES GROUP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 88597</AddressLine1Txt>
            <CityNm>MILWAUKEE</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53288</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT CONSULTING SERVICES</ServicesDesc>
        <CompensationAmt>296363</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CITICLEAN JANITORIAL SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2173 EAST COLLEGE AVE</AddressLine1Txt>
            <CityNm>STATE COLLEGE</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>16801</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HOUSEKEEPING SERVICES</ServicesDesc>
        <CompensationAmt>154694</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JPT ARCHITECTS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>244 WALNUT STREET</AddressLine1Txt>
            <CityNm>JOHNSTOWN</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>15901</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DESIGN SERVICES</ServicesDesc>
        <CompensationAmt>153448</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>89262</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>97489</GovernmentGrantsAmt>
      <TotalContributionsAmt>186751</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621300</BusinessCd>
        <TotalRevenueColumnAmt>63764118</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>63764118</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PHYSICIAN FEES</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>4480</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4480</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>63768598</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1541</TotalRevenueColumnAmt>
        <ExclusionAmt>1541</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>668666</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>668666</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
      </RentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>39348</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>4411</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>34937</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>34937</TotalRevenueColumnAmt>
        <ExclusionAmt>34937</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>HOSPITALIST REV</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>3733099</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3733099</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MNPG SERVICES CCP</Desc>
        <BusinessCd>999999</BusinessCd>
        <TotalRevenueColumnAmt>1145593</TotalRevenueColumnAmt>
        <ExclusionAmt>1145593</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>TEACHING STIPENDS</Desc>
        <BusinessCd>999999</BusinessCd>
        <TotalRevenueColumnAmt>633905</TotalRevenueColumnAmt>
        <ExclusionAmt>633905</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>1060030</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>460032</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>599998</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>6572627</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>70564454</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>67961729</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>2415974</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>6840697</TotalAmt>
        <ProgramServicesAmt>6840697</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>59469724</TotalAmt>
        <ProgramServicesAmt>58068695</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1401029</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>2680077</TotalAmt>
        <ProgramServicesAmt>2616938</ProgramServicesAmt>
        <ManagementAndGeneralAmt>63139</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>6312161</TotalAmt>
        <ProgramServicesAmt>5844863</ProgramServicesAmt>
        <ManagementAndGeneralAmt>467298</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>3136210</TotalAmt>
        <ProgramServicesAmt>3040459</ProgramServicesAmt>
        <ManagementAndGeneralAmt>95751</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>13030137</TotalAmt>
        <ProgramServicesAmt>2136823</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10893314</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>2945</TotalAmt>
        <ProgramServicesAmt>2945</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>396151</TotalAmt>
        <ProgramServicesAmt>286896</ProgramServicesAmt>
        <ManagementAndGeneralAmt>109255</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>1266042</TotalAmt>
        <ProgramServicesAmt>22873</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1243169</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>4211235</TotalAmt>
        <ProgramServicesAmt>3978245</ProgramServicesAmt>
        <ManagementAndGeneralAmt>232990</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>38613</TotalAmt>
        <ProgramServicesAmt>37464</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1149</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>1539</TotalAmt>
        <ProgramServicesAmt>1189</ProgramServicesAmt>
        <ManagementAndGeneralAmt>350</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>3003469</TotalAmt>
        <ProgramServicesAmt>1598675</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1404794</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>1173558</TotalAmt>
        <ProgramServicesAmt>1173558</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>6468232</TotalAmt>
        <ProgramServicesAmt>6467268</ProgramServicesAmt>
        <ManagementAndGeneralAmt>964</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>ADMINISTRATION ALLOCATI</Desc>
        <TotalAmt>602072</TotalAmt>
        <ProgramServicesAmt>602072</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MINOR EQUIPMENT</Desc>
        <TotalAmt>210004</TotalAmt>
        <ProgramServicesAmt>207430</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2574</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LAUNDRY &amp; LINEN</Desc>
        <TotalAmt>167483</TotalAmt>
        <ProgramServicesAmt>167483</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>405403</TotalAmt>
        <ProgramServicesAmt>299754</ProgramServicesAmt>
        <ManagementAndGeneralAmt>105649</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>109415752</TotalAmt>
        <ProgramServicesAmt>93394327</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16021425</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>10376</BOYAmt>
        <EOYAmt>10424</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>38198090</BOYAmt>
        <EOYAmt>2049577</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>5902074</BOYAmt>
        <EOYAmt>5338711</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>241980</BOYAmt>
        <EOYAmt>238995</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1030846</BOYAmt>
        <EOYAmt>625338</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>33001712</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>23452595</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>11503660</BOYAmt>
        <EOYAmt>9549117</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>1960598</BOYAmt>
        <EOYAmt>1661992</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>18107868</BOYAmt>
        <EOYAmt>15270582</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>76955492</BOYAmt>
        <EOYAmt>34744736</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>6943812</BOYAmt>
        <EOYAmt>8280399</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>20318803</BOYAmt>
        <EOYAmt>15622758</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>27262615</BOYAmt>
        <EOYAmt>23903157</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>49692877</BOYAmt>
        <EOYAmt>10841579</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>49692877</BOYAmt>
        <EOYAmt>10841579</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>76955492</BOYAmt>
        <EOYAmt>34744736</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-38851298</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>17195770</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>24762317</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>31959548</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>58967828</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>186751</CurrentTaxYearAmt>
        <TotalAmt>133072214</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>59548364</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>62088893</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>57751830</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>60907781</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>67961729</CurrentTaxYearAmt>
        <TotalAmt>308258597</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>76744134</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>86851210</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>89711378</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>119875609</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>68148480</CurrentTaxYearAmt>
        <TotalAmt>441330811</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>441330811</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>686847</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>687957</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>688736</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>730340</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>670207</CurrentTaxYearAmt>
        <TotalAmt>3464087</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>686847</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>687957</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>688736</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>730340</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>670207</CurrentTaxYearAmt>
        <TotalAmt>3464087</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <CurrentTaxYearMinus3YearsAmt>39377</CurrentTaxYearMinus3YearsAmt>
        <TotalAmt>39377</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>2425594</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3417026</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3219579</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2149760</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2379496</CurrentTaxYearAmt>
        <TotalAmt>13591455</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>79856575</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>90995570</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>93619693</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>122755709</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>71198183</CurrentTaxYearAmt>
        <TotalAmt>458425730</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.96270</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.96410</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00760</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00720</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>BMI INCOME - 2017 AMOUNT: $ 48,662. 2018 AMOUNT: $ 56,997. 2019 AMOUNT: $ 43,774. 2020 AMOUNT: $ 50,148. 2021 AMOUNT: $ 86,943. COURIER SERVICES - 2017 AMOUNT: $ 118,283. 2018 AMOUNT: $ 102,843. 2019 AMOUNT: $ 139,435. 2020 AMOUNT: $ 137,247. 2021 AMOUNT: $ 130,635. FITNESS CENTER - 2017 AMOUNT: $ 98,209. 2018 AMOUNT: $ 101,482. 2019 AMOUNT: $ 80,062. 2020 AMOUNT: $ 75,477. 2021 AMOUNT: $ 102,428. MEDICAL DIRECTOR - 2017 AMOUNT: $ 236,602. 2018 AMOUNT: $ 281,624. 2019 AMOUNT: $ 272,916. 2020 AMOUNT: $ 285,009. 2021 AMOUNT: $ 210,560. MISCELLANEOUS - 2017 AMOUNT: $ 23,176. 2018 AMOUNT: $ 4,240. 2019 AMOUNT: $ 5,115. 2020 AMOUNT: $ 3,978. 2021 AMOUNT: $ 4,854. MNPG SERVICES CCP - 2017 AMOUNT: $ 1,124,766. 2018 AMOUNT: $ 1,408,655. 2019 AMOUNT: $ 1,233,675. 2020 AMOUNT: $ 946,100. 2021 AMOUNT: $ 1,145,593. PURCHASE DISCOUNTS - 2017 AMOUNT: $ 58,478. 2018 AMOUNT: $ 82,775. 2019 AMOUNT: $ 100,126. 2020 AMOUNT: $ 71,669. 2021 AMOUNT: $ 64,578. RETAIL SALES - 2017 AMOUNT: $ 100. TEACHING STIPENDS - 2017 AMOUNT: $ 717,318. 2018 AMOUNT: $ 878,410. 2019 AMOUNT: $ 1,031,760. 2020 AMOUNT: $ 431,158. 2021 AMOUNT: $ 633,905. QUALITY INCENTIVE INCOME - 2018 AMOUNT: $ 500,000. 2019 AMOUNT: $ 312,716. 2020 AMOUNT: $ 148,974.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <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>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>175000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>175000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>4318988</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>770661</DepreciationAmt>
        <BookValueAmt>3548327</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>16051145</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>13166698</DepreciationAmt>
        <BookValueAmt>2884447</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>12249698</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>9515236</DepreciationAmt>
        <BookValueAmt>2734462</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>206881</OtherCostOrOtherBasisAmt>
        <BookValueAmt>206881</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>9549117</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>BMI PARTNERSHIP INTEREST</Desc>
        <BookValueAmt>824178</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>DUE FROM AFFILIATES</Desc>
        <BookValueAmt>2422</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OPERATING LEASE OBLIGATIONS</Desc>
        <BookValueAmt>13722282</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>ESTIMATED MEDICAL MALPRACTICE</Desc>
        <BookValueAmt>721700</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>15270582</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED MALPRACTICE</Desc>
        <Amt>1618929</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OPERATING LEASE OBLIGATIONS</Desc>
        <Amt>14003829</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>15622758</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>71035396</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>-108462</OtherRevenueAmt>
      <RevenueNotReportedAmt>-108462</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>71143858</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>-579404</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-579404</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>70564454</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>109886694</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>579404</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>579404</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>109307290</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>108462</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>108462</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>109415752</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSES -108,462.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES -668,666. TRANSFER FROM FOUNDATION NETTED ON F/S 89,262.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES 668,666. TRANSFER FROM FOUNDATION NETTED ON F/S -89,262.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSES 108,462.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MOUNT NITTANY MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1800 EAST PARK AVENUE</AddressLine1Txt>
          <CityNm>STATE COLLEGE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16803</ZIPCd>
        </USAddress>
        <RecipientEIN>240795682</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>6840697</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>PROVIDE FINANCIAL SUPPORT TO AFFILIATE</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>ASSISTANCE IS PROVIDED TO RELATED ENTITIES FOR FINANCIAL SUPPORT. MANAGEMENT OF THE ORGANIZATION OVERSEES THE USE OF FUNDS AT THE AFFILIATED ENTITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>1</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATHLEEN RHINE</PersonNm>
        <TitleTxt>PRESIDENT/CHIEF EXECUTIVE OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>819957</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>262763</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>16879</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>124052</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10315</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1233966</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES LEIB DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>459876</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>379814</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>21640</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21218</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>882548</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>VEERAL PATEL MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>791807</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>25677</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20067</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>203</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>35536</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>873290</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES MARTIN MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>728387</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>80000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20726</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>203</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>29726</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>859042</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRIAN SPENCER DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>720255</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>80000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20111</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>1703</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23009</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>845078</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEPHEN PHILLIPS DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>610393</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>120580</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20067</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>953</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16173</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>768166</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRYAN ROACH</PersonNm>
        <TitleTxt>EXECUTIVE VP &amp; CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>485427</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>107092</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>7112</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>19884</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>29138</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>648653</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTOPHER YINGLING MD</PersonNm>
        <TitleTxt>SECRETARY/TREASURER</TitleTxt>
        <BaseCompensationFilingOrgAmt>513316</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>77873</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20068</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>1703</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>30684</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>643644</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EMILY PETERSON MD</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>556734</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>18677</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20111</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>203</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>30411</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>626136</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTOPHER HESTER MD</PersonNm>
        <TitleTxt>PRIMARY CARE CHIEF</TitleTxt>
        <BaseCompensationFilingOrgAmt>339294</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>39104</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20910</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>203</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>29711</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>429222</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JEFFREY PRO MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>341152</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>13416</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20736</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>203</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>30411</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>405918</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES PROWANT</PersonNm>
        <TitleTxt>CHIEF OPERATING OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>298043</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>39808</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>26480</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>203</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25836</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>390370</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LANCE ROSE</PersonNm>
        <TitleTxt>FORMER CEO/OFFICER/DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>14721</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>14721</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CEO IS AN EMPLOYEE OF MOUNT NITTANY MEDICAL CENTER ("MNMC"). MNMC USES ALL OF THE METHODS UNDER LINE 3 OTHER THAN REVIEWING 990S OF OTHER ORGANIZATIONS TO ESTABLISH HER COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINES 4A-B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORMER CEO, LANCE ROSE, RECEIVED A NONQUALIFIED RETIREMENT PLAN PAYMENT OF $14,721 DURING THE CALENDAR YEAR. THE CHIEF EXECUTIVE OFFICER, KATHLEEN RHINE, PARTICIPATES IN 457(F) NON-QUALIFIED RETIREMENT PLAN. CONTRIBUTIONS MADE DURING THE CALENDAR YEAR WERE $104,168. THERE WERE NO DISTRIBUTIONS IN DURING THE CALENDAR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE TEAM MEMBERS OF MOUNT NITTANY MEDICAL CENTER AND THE MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES (D/B/A MOUNT NITTANY PHYSICIAN GROUP) EXECUTIVE DIRECTOR RECEIVED A PORTION OF THEIR ANNUAL VARIABLE-PAY BASED UPON THE CONSOLIDATED OPERATING MARGIN, MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES' (D/B/A MOUNT NITTANY PHYSICIAN GROUP) OPERATING MARGIN, CONTRIBUTIONS, AND OTHER CORPORATE GOALS. THE CORPORATE GOALS FOCUSED ON (1) PROVIDING LOCALIZED CARE, INTEGRATED CARE, EFFICIENT CARE, AND ALIGNED CARE; (2) FINANCE; (3) QUALITY/PATIENT SAFETY; AND (4) THE WORK ENVIRONMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>ADAM J MURRAY</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>101567</TransactionAmt>
        <TransactionDesc>SEE PART V</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCH L, PART IV:</FormAndLineReferenceDesc>
        <ExplanationTxt>(A) NAME OF INTERESTED PERSON: ADAM MURRAY(B) RELATIONSHIP BETWEEN INTEREST PERSON AND ORGANIZATION: ADAM MURRAY IS A FAMILY MEMBER OF R. KEVIN MURRAY WHO IS A BOARD DIRECTOR.(D) DESCRIPTION OF TRANSACTION: SALARY COMPENSATION FROM MOUNT NITTANY MEDICAL CENTER, A RELATED ORGANIZATION.(A) NAME OF INTERESTED PERSON: AMANDA LAUER(B) RELATIONSHIP BETWEEN INTEREST PERSON AND ORGANIZATION: AMANDA LAUER IS A FAMILY MEMBER OF R. KEVIN MURRAY WHO IS A BOARD DIRECTOR.(D) DESCRIPTION OF TRANSACTION: SALARY COMPENSATION FROM MOUNT NITTANY MEDICAL CENTER, A RELATED ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>AS THE PARENT ENTITY, MOUNT NITTANY HEALTH SYSTEM (MNHS) HAS THE RIGHT TO APPOINT AND REMOVE, OR APPROVE THE REMOVAL OF, ANY AND ALL DIRECTORS OF THE CORPORATION, WITH THE EXCEPTION OF EX-OFFICIO DIRECTORS AND PHYSICIAN DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>MNHS HAS THE FOLLOWING POWERS: (A) TO APPOINT AND REMOVE, OR APPROVE THE REMOVAL OF, ANY AND ALL DIRECTORS OF THE CORPORATION, WITH THE EXCEPTION OF EX-OFFICIO DIRECTORS AND PHYSICIAN DIRECTORS; (B) TO APPROVE THE ELECTION OF AND TO REMOVE ANY AND ALL OFFICERS OF THE CORPORATION; (C) TO APPROVE THE PHYSICIAN EMPLOYMENT CONTRACT OF A PHYSICIAN WHO IS A DISQUALIFIED PERSON WITH RESPECT TO THE CORPORATION, WITHIN THE MEANING OF 4958(F)(1) OF THE CODE (OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW) AND THE TREASURY REGULATIONS THEREUNDER, AND ALL OTHER PHYSICIAN EMPLOYMENT CONTRACTS SUBJECT TO THE PHYSICIAN COMPENSATION POLICY OF THE PARENT; (D) TO DEVELOP AND APPROVE ALL ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION (INCLUDING ALL AMENDMENTS THERETO); (E) TO APPROVE THE INCURRENCE, RE-FINANCING, OR PREPAYMENT OF ANY INDEBTEDNESS OF THE CORPORATION; (F) TO INITIATE OR APPROVE THE SALE, MORTGAGE, LEASE, OR DISPOSAL OF ANY OF THE CORPORATION'S REAL PROPERTY; (G) TO APPROVE THE SECURING OF ANY MORTGAGE, DEED OF TRUST, PLEDGE, SECURITY INTEREST, OR OTHER ENCUMBRANCE OF THE CORPORATION; (H) EXCEPT AS MAY BE INVOLVED THEREAFTER IN ORDINARY REPAIRS, MAINTENANCE, AND REPLACEMENT, AND EXCEPT AS MAY HAVE ALREADY BEEN APPROVED AS PART OF THE CAPITAL BUDGET, TO APPROVE THE MAKING OF ANY CAPITAL EXPENDITURE OR CAPITAL ADDITION OR IMPROVEMENT; (I) TO APPROVE ALL UNBUDGETED EXPENDITURES IN EXCESS OF 1% OF EACH SUCH BUDGET; (J) TO APPROVE THE MOVEMENT OF FUNDS TO AND FROM THIS CORPORATION TO THE PARENT OR OTHER ENTITIES RELATED TO THE PARENT; (K) TO APPROVE ALL STRATEGIC PLANS OF THE CORPORATION; (L) TO SELECT THE INDEPENDENT AUDITORS AND LEGAL COUNSEL OF THE CORPORATION; (M) TO AMEND OR TO APPROVE AMENDMENTS, ALTERATIONS AND MODIFICATIONS TO OR REPEALS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION IN ACCORDANCE WITH SECTION 12.1; (N) TO ENTER INTO, AMEND, OR TERMINATE ANY AGREEMENT WITH A MATERIAL THIRD PARTY PAYOR OF THE CORPORATION, AS DETERMINED BY THE PARENT IN ITS SOLE DISCRETION; (O) TO APPROVE ALL AMENDMENTS TO ARTICLES OF INCORPORATION, MERGERS, CONSOLIDATIONS, DIVISIONS, SALES OF SUBSTANTIALLY ALL ASSETS, LIQUIDATION OR DISSOLUTION OF THE CORPORATION, AND ALL OTHER FUNDAMENTAL CHANGE TRANSACTIONS, AS WELL AS ALL TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS; (P) TO ESTABLISH, TERMINATE, OR WITHDRAW FROM ANY SUBSIDIARY, JOINT VENTURE, OR OTHER PARTNERSHIP OR SHARED GOVERNANCE AGREEMENT; (Q) TO ENTER INTO, AMEND, OR TERMINATE ANY AGREEMENT BETWEEN THE CORPORATION AND THE PARENT; (R) TO ENTER INTO, AMEND, OR TERMINATE AN AFFILIATION AGREEMENT WITH ANY HOSPITAL, PROVIDER, PAYOR, OR HEALTH CARE SYSTEM; (S) TO APPROVE ANY MATERIAL CHANGE IN MISSION OR STRATEGIC DIRECTION OF THE CORPORATION; AND (T) TO TAKE ANY OTHER ACTION THAT IS RESERVED TO THE PARENT FROM TIME TO TIME BY THE CORPORATION'S BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990 WAS PROVIDED TO THE BOARD OF DIRECTORS AND TO THE MOUNT NITTANY HEALTH SYSTEM AUDIT COMMITTEE BEFORE BEING FILED WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUALLY, THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO KEY MEMBERS OF THE ORGANIZATION INCLUDING BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. EACH PERSON MUST REPORT ANY POTENTIAL CONFLICTS OF INTEREST. REPORTED CONFLICTS ARE THEN REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AND THE HEALTH SYSTEM'S AUDIT COMMITTEE. THE CONFLICT OF INTEREST REPORT IS THEN SUBMITTED TO THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS AND EXECUTIVE &amp; PHYSICIAN COMPENSATION COMMITTEE REVIEW COMPENSATION PAID TO EXECUTIVE MANAGEMENT TEAM IN CONJUNCTION WITH AN INDEPENDENT THIRD PARTY CONSULTING FIRM TO ENSURE COMPENSATION IS REASONABLE AND APPROPRIATE FOR DUTIES AND RESPONSIBILITES ASSIGNED. THE PROCESS IS DESIGNED TO ENABLE THE HEALTH SYSTEM TO ATTRACT, MOTIVATE, AND RETAIN THE HIGHLY SKILLED EXECUTIVE TALENT NEEDED TO CARRY OUT ITS MISSION AND STRATEGIC OBJECTIVES THROUGH THE ESTABLISHMENT OF SALARIES, BENEFITS, AND VARIABLE PAY OPPORTUNITIES THAT ARE REASONABLE, COMPARABLE WITH THOSE FOR SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT ORGANIZATIONS, AND REWARD ACHIEVEMENT OF ORGANIZATIONAL AND INDIVIDUAL OBJECTIVES. THE EXECUTIVE &amp; PHYSICIAN COMPENSATION COMMITTEE ENSURES THAT THE BOARD FULLY UNDERSTANDS THE PROCESS BY WHICH THE ORGANIZATION'S OFFICERS/KEY EMPLOYEES COMPENSATION DECISIONS ARE MADE. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE IRS INTERMEDIATE SANCTIONS RULES. THE COMMITTEE REPORTS ITS ACTIVITIES TO THE BOARD, INCLUDING THE SPECIFIC DETAILS OF COMPENSATION ACTIONS. THE BOARD HAS DELEGATED TO THE COMMITTEE THE AUTHORITY TO MAKE COMPENSATION DECISIONS. THE BOARD BEARS THE ULTIMATE RESPONSIBILITY FOR ENSURING SOUND DECISION-MAKING IN THIS AREA. REVIEW AND APPROVAL OF COMPENSATION IS DOCUMENTED VIA MINUTES OF COMMITTEE MEETINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>SHREDDING: PROGRAM SERVICE EXPENSES 19,373. MANAGEMENT AND GENERAL EXPENSES 2,208. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,581. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,087,703. MANAGEMENT AND GENERAL EXPENSES 78,668. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,166,371. BILLING: PROGRAM SERVICE EXPENSES 1,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,260. PHYSICIAN LOCUM: PROGRAM SERVICE EXPENSES 878,033. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 878,033. CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 902,684. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 902,684. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 150,454. MANAGEMENT AND GENERAL EXPENSES 9,909,754. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,060,208.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MOUNT NITTANY MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1800 EAST PARK AVE</AddressLine1Txt>
          <CityNm>STATE COLLEGE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16803</ZIPCd>
        </USAddress>
        <EIN>240795682</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MOUNT NITTANY HEALTH SYSTEM</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1800 EAST PARK AVE</AddressLine1Txt>
          <CityNm>STATE COLLEGE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16803</ZIPCd>
        </USAddress>
        <EIN>571138956</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING AND SUPPORT FOR AFFILIATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MOUNT NITTANY MEDICAL CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MOUNT NITTANY MEDICAL CENTER WORKMEN'S COMPENSATION SELF INSURANCE TRUST</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1800 EAST PARK AVE</AddressLine1Txt>
          <CityNm>STATE COLLEGE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16803</ZIPCd>
        </USAddress>
        <EIN>256440788</EIN>
        <PrimaryActivitiesTxt>PROVIDE WORKMEN'S COMPENSATION BENEFITS TO EMPLOYEES OF AFFILIATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MOUNT NITTANY MEDICAL CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MOUNT NITTANY HEALTH SYSTEM</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1800 EAST PARK AVE</AddressLine1Txt>
          <CityNm>STATE COLLEGE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16803</ZIPCd>
        </USAddress>
        <EIN>800663092</EIN>
        <PrimaryActivitiesTxt>MANAGEMENT AND ADMINISTRATIVE SUPPORT FOR AFFILIATES.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CENTRE COUNTY CHILDREN'S ADVOCACY CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1800 EAST PARK AVE</AddressLine1Txt>
          <CityNm>STATE COLLEGE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16803</ZIPCd>
        </USAddress>
        <EIN>460871813</EIN>
        <PrimaryActivitiesTxt>CHILD-FOCUSED APPROACH TO CHILD ABUSE CASES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MOUNT NITTANY MEDICAL CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
