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        <ExplanationTxt>Kettering Health Network has a policy on conservation easements. The expense to monitor the conservation easement is recorded as incurred to the hospital. There is no income from the easement, and no asset has been recorded.</ExplanationTxt>
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      <SupplementalInformationDetail>
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      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>3791220</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>956743</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>2834477</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00560</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <CashAndInKindContributionsGrp>
        <TotalCommunityBenefitExpnsAmt>746490</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>746490</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00150</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>23503094</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>5428384</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>18074710</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03590</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>141682430</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>72308137</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>69374293</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.13810</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>39913756</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>957930</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>91714005</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>92472583</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-758578</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>1 Grandview Associates</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>Medical Office Building</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.92000</OrgProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.08000</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>2 Southview Orthopedic Center Management Company LLC</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>Medical Service Venture</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.51000</OrgProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.49000</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <HospitalFacilitiesCnt>2</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>Grandview Medical Center</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>405 W Grand Avenue</AddressLine1Txt>
          <CityNm>Dayton</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45405</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>ketteringhealth.org</WebsiteAddressTxt>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>2</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>Southview Medical Center</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1997 Miamisburg Centerville Road</AddressLine1Txt>
          <CityNm>Centerville</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45459</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>ketteringhealth.org</WebsiteAddressTxt>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>Grandview Medical Center Group A</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>19</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>1</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>1</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>https://www.ketteringhealth.org/aboutus/communityhealth.cfm</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>19</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>https://www.ketteringhealth.org/aboutus/communityhealth.cfm</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>250.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>400.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>https://www.ketteringhealth.org/financial/pdfs/PatientFinancialAssistancePo</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>https://www.ketteringhealth.org/financial/pdfs/HCAP-2019b.pdf</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>https://www.ketteringhealth.org/financial/pdfs/PLS3.pdf</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Section A:</FormAndLineReferenceDesc>
        <ExplanationTxt>Each facility listed is required to be licensed, registered, or recognized as a healthcare facility under state law.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Section B</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility Reporting Group A</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility Reporting Group A consists of:</FormAndLineReferenceDesc>
        <ExplanationTxt>- Facility 1: Grandview Medical Center, - Facility 2: Southview Medical Center</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- Grandview Medical Center Part V, Section B, line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Nonprofit hospitals in the Greater Cincinnati and Greater Dayton regions combined their efforts and resources to produce a comprehensive and collaborative Community Health Needs Assessment (CHNA). The CHNA Team involved four entities working closely together: The Health Collaborative (lead agency); the Greater Dayton Area Hospital Association; Gwen Finegan (lead consultant and project manager); and Public Health - Dayton &amp; Montgomery County (secondary data collection for Ohio counties). The Southwest District of the Association of Ohio Health Commissioners also partnered in the effort. They provided representatives who could speak on the behalf of the 17 Ohio counties served by the hospitals. All county-level public health departments completed surveys, plus 5 city health departments.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- Grandview Medical Center Part V, Section B, line 6a:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Christ Hospital Health NetworkCincinnati Children's Hospital Medical CenterClinton Memorial HospitalHighpoint HealthFort Hamilton HospitalGrandview Medical CenterGreene Memorial HospitalKettering Behavioral Medicine CenterKettering Medical CenterSoin Medical CenterSouthview Medical CenterSycamore Medical CenterLindner Center of HopeMercy Health - Anderson HospitalMercy Health - Clermont HospitalMercy Health - Fairfield HospitalMercy Health - West HospitalThe Jewish Hospital - Mercy HealthMercy Health | Springfield Urbana regionMercy Health - Urbana HospitalSpringfield Regional Medical CenterAtrium Medical CenterMiami Valley HospitalMiami Valley Hospital NorthMiami Valley Hospital SouthUpper Valley Medical CenterBethesda Butler HospitalBethesda North HospitalGood Samaritan HospitalMcCullough-Hyde Memorial HospitalTriHealth Evendale Hospital Daniel Drake Center for Post-Acute CareUniversity of Cincinnati Medical Center West Chester HospitalWilson HealthWayne HealthCare</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- Grandview Medical Center Part V, Section B, line 6b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Health CollaborativeGreater Dayton Area Hospital AssociationGwen FineganPublic Health - Dayton &amp; Montgomery CountySouthwest District of the Association of Ohio Health Commissioners</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- Grandview Medical Center Part V, Section B, line 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>The priorities for Grandview Medical Center and Southview Medical Center are the top community health needs identified in the Community Health Needs Assessment (CHNA):1. Mental health, including substance abuse2. Access to care and/or services, including food insecurity and infant mortality3. Chronic disease4. Healthy behaviorsThese will be addressed through support for Primary Health Solutions FQHC, Community Health Centers, Hope for Homeless, Good Neighbor House, congregational health, Hope Center for Families, executive physicals for pastors, cancer support group, Gem City Market (mobile grocery &amp; teaching kitchen), Pop-up Market, Infant Mortality Task Force (EveryOne Reach One), Help Me Grow, Tobacco Cessation Baby &amp; Me Tobacco Free (through Envision) and OneFifteen, as well as referrals to prenatal care from the emergency department.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Southview Medical Center Part V, Section B, line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Nonprofit hospitals in the Greater Cincinnati and Greater Dayton regions combined their efforts and resources to produce a comprehensive and collaborative Community Health Needs Assessment (CHNA). The CHNA Team involved four entities working closely together: The Health Collaborative (lead agency); the Greater Dayton Area Hospital Association; Gwen Finegan (lead consultant and project manager); and Public Health - Dayton &amp; Montgomery County (secondary data collection for Ohio counties). The Southwest District of the Association of Ohio Health Commissioners also partnered in the effort. They provided representatives who could speak on the behalf of the 17 Ohio counties served by the hospitals. All county-level public health departments completed surveys, plus 5 city health departments.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Southview Medical Center Part V, Section B, line 6a:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Christ Hospital Health NetworkCincinnati Children's Hospital Medical CenterClinton Memorial HospitalHighpoint HealthFort Hamilton HospitalGrandview Medical CenterGreene Memorial HospitalKettering Behavioral Medicine CenterKettering Medical CenterSoin Medical CenterSouthview Medical CenterSycamore Medical CenterLindner Center of HopeMercy Health - Anderson HospitalMercy Health - Clermont HospitalMercy Health - Fairfield HospitalMercy Health - West HospitalThe Jewish Hospital - Mercy HealthMercy Health | Springfield Urbana regionMercy Health - Urbana HospitalSpringfield Regional Medical CenterAtrium Medical CenterMiami Valley HospitalMiami Valley Hospital NorthMiami Valley Hospital SouthUpper Valley Medical CenterBethesda Butler HospitalBethesda North HospitalGood Samaritan HospitalMcCullough-Hyde Memorial HospitalTriHealth Evendale Hospital Daniel Drake Center for Post-Acute CareUniversity of Cincinnati Medical Center West Chester HospitalWilson HealthWayne HealthCare</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Southview Medical Center Part V, Section B, line 6b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Health CollaborativeGreater Dayton Area Hospital AssociationGwen FineganPublic Health - Dayton &amp; Montgomery CountySouthwest District of the Association of Ohio Health Commissioners</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Southview Medical Center Part V, Section B, line 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>The priorities for Kettering Medical Center and Sycamore Medical Center are the top community health needs identified in the Community Health Needs Assessment (CHNA):1. Mental health, including substance abuse2. Access to care and/or services, including food insecurity and infant mortality3. Chronic disease4. Healthy behaviorsThese will be addressed through support for Primary Health Solutions FQHC, Good Neighbor House, congregational health, Mobile Grocery, Tobacco Cessation Baby &amp; Me Tobacco Free (through Envision), hospital-based tobacco cessation, OneFifteen, and Brigid's Path, as well as referrals to prenatal care from the emergency department.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>11</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - Beavercreek Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2510 Commons Boulevard</AddressLine1Txt>
            <CityNm>Beavercreek</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45431</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - Cornerstone Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7740 Washington Village Drive</AddressLine1Txt>
            <CityNm>Centerville</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45459</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - Corwin M Nixon Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1470 N Broadway</AddressLine1Txt>
            <CityNm>Lebanon</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45036</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - Dayton Medical Imaging</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>113 W National Road</AddressLine1Txt>
            <CityNm>Vandalia</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45377</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>5 - Englewood Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1250 National Road</AddressLine1Txt>
            <CityNm>Englewood</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45322</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>6 - Huber Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>8701 Old Troy Pike</AddressLine1Txt>
            <CityNm>Huber Heights</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45424</ZIPCd>
          </USAddress>
          <FacilityTxt>Emergency, Outpatient Clinic, &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>7 - Preble County Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>450-B Washington-Jackson Road</AddressLine1Txt>
            <CityNm>Eaton</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45320</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>8 - Sugarcreek Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>6438 Wilmington Pike</AddressLine1Txt>
            <CityNm>Dayton</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45459</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>9 - Troy Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>700 South Stanfield Rd Suite B</AddressLine1Txt>
            <CityNm>Troy</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45373</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>10 - Victor J Cassano Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>165 Edwin C Moses Boulevard</AddressLine1Txt>
            <CityNm>Dayton</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45402</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>11 - Yankee Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7677 Yankee Street</AddressLine1Txt>
            <CityNm>Centerville</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45459</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 6a:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization provides an annual community benefit report that is made available to the public.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>Charity care is calculated using a cost to charge ratio following the methodology of Worksheet 2. Medical costs are calculated using a cost accounting system that addresses all patient segments. Community health improvement services are calculated on the basis of direct expenditures. Health professions education is calculated based on the Medicare cost report. Subsidized health services is calculated based on the non-Medicare, Medicaid and charity care proportion of departmental losses for the specific programs. Cash and in-kind contributions are calculated on the basis of direct expenditures.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7g:</FormAndLineReferenceDesc>
        <ExplanationTxt>Subsidized health services represent the non-needs based and non-Medicare program losses of services the hospital offers.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>An industry average was used to estimate this amount. It was not included as part of community benefit.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debt footnote extract:Implicit price concessions represent differences between amounts billed and the estimated consideration the Network expects to receive from patients, which are determined based on historical collection experience, current market conditions, and other factors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>The costing methodology used to determine Medicare costs is the Medicare cost report. Medicare costs have not been included in community benefit in Part I.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Financial counselors work out a payment program for any amount due after the Charity Sliding Scale Discounts are applied. Collection procedures consistent with self-pay accounts are applied to these balances.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Grandview, as part of Kettering Health Network, has dedicated an entire department to community health and wellness. The Community Outreach Department is comprised of coordinators who develop programs, screenings and other health related events. The department also has fitness specialists, nurses, dietitians, massage and behavioral therapists, a communication specialist, health coaches, a physician medical director, a full service call center, and many other resource personnel.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>Grandview informs and educates patients or persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under Grandview's charity care policy as follows:-Grandview has a financial assistance brochure that is included in all of the patient information kits given at the time of intake or registration into any facility or department.-There is information posted in all of the admitting and registration areas about charity care and financial assistance.-During the registration process there is specific scripting to ask patients if they would like to disclose family size and income to screen them for federal/state/local and hospital based charity/assistance programs. This data is available for future visits as well.-Grandview has the reporting capability to review and screen any patient who may have been admitted during registration "off hours" for eligibility and assistance.-Grandview contracts with an outside agency for patient assistance in the application process.-The back of the patient statement shows the current and prior year Federal Poverty Guidelines and has the Financial Assistance Form to complete and mail in for consideration for Grandview's HCAP or Charity Sliding Scale program.-Grandview's patient account representatives in customer service screen patients that are unable to pay their bill for the various financial assistance programs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>KHN serves a population of approximately 1,574,000. The seven-county service area includes Butler, Clark, Greene, Miami, Montgomery, Preble, and Warren counties. Eighteen zip codes within this service area received a Community Need Index score of 3.4 or greater. The Community Need Index identifies the severity of healthcare disparities based upon certain barriers known to limit healthcare access. A score of 1.0 indicates a zip code with the lowest socio-economic barriers (low need), while a score of 5.0 represents a zip code with the most socio-economic barriers (high need).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Grandview furthers its exempt purpose by promoting the health of the community by:-Retaining a Board of Directors with a majority (excluding employees and contractors) living in the primary service area;-Extending medical staff privileges to all qualified physicians in its community for a majority of its departments;-Utilizing surplus funds to help support ongoing improvements in patient care through equipment upgrades, acquisition of the most advanced medical technology, upgrades of existing hospital structures, and construction of new facilities in order to provide accessible, efficient, quality care. -Providing a nationally-recognized osteopathic teaching program.-Supporting medical research through the Innovation Center, cultivating new technologies and fostering best practices among partners from industry, academia, and health care.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>Grandview and its affiliates promote the health of the communities served by the system as described below:-Grandview, a part of the Kettering Health Network, is dedicated to the creation and maintenance of community wellness programs, support groups and health education programs. Grandview provides numerous screenings, family-focused classes, health fairs, conferences, donations, and education programs to ensure the long-term wellbeing of people living in the community.-Grandview provides a teaching program for osteopathic physicians.-The Grandview Foundation is the philanthropic arm of Grandview Medical Center and supports the education of future osteopathic physicians.-Kettering Affiliated Health Services, Inc includes Sycamore Glen Health Center and Sycamore Glen Retirement Community. These healthcare areas provide services to the surrounding communities which complement those services provided by Grandview as part of the Kettering Health Network.-Medical research is supported through the Innovation Center, which cultivates new technologies and fosters best practices among partners from industry, academia, and health care.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7, Reports Filed With States</FormAndLineReferenceDesc>
        <ExplanationTxt>OH</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc1041900001">
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        <GrantTypeTxt>Patient assistance</GrantTypeTxt>
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        <CashGrantAmt>26340</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Assistance to employees for hardship</GrantTypeTxt>
        <RecipientCnt>40</RecipientCnt>
        <CashGrantAmt>25106</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Scholarships</GrantTypeTxt>
        <RecipientCnt>4</RecipientCnt>
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      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Funds are monitored and use is determined by board members.</ExplanationTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lewis Rebecca</PersonNm>
        <TitleTxt>President - Grandview Medical Center</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Bulow Robert E</PersonNm>
        <TitleTxt>Physician until 8/19</TitleTxt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <PersonNm>Manchur Richard</PersonNm>
        <TitleTxt>President of SVH until 11/2019; Pres</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sefton John C</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <TotalCompensationFilingOrgAmt>168813</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Moore Terri</PersonNm>
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        <TotalCompensationFilingOrgAmt>180678</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Anderson Todd</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Chanaga Luis</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation is established by a related organization. The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Network has a supplemental executive retirement plan available only to a certain class of management.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Col Biii</FormAndLineReferenceDesc>
        <ExplanationTxt>Column Biii includes compensation reported on the W-2 that may or may not have gone through the current year Statement of Operations and Changes in Net Assets.</ExplanationTxt>
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    </IRS990ScheduleJ>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Fred Manchur, CEO - KHN, is the father of Richard Manchur, President SVMC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A tax specialist is engaged to review the 990. The 990 is reviewed and accepted by the audit committee which reports this to the governing body (board).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Network regularly and consistently monitors and enforces compliance with the conflict of interest policy by making it part of the employees' annual reviews. Employees must certify that they have read the conflict of interest policy and have disclosed any potential conflicts and agree to immediately notify Corporate Integrity if one should arise. Board members are required to annually review the Network's policy, sign a conflict of interest statement, and notify the Network if a conflict should arise.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's governing documents, conflict of interest policy, and financial statements are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Net transfers to affiliate -25,631,291. Change in plan assets and benefit obligation of pension plan 2,012,103. Other changes, net 2,241,727.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>Neither the oversight process nor the selection process changed during the tax year.</ExplanationTxt>
      </SupplementalInformationDetail>
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          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
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        <EIN>311175717</EIN>
        <PrimaryActivitiesTxt>Physician Services</PrimaryActivitiesTxt>
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        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Beavercreek Medical Center</BusinessNameLine1Txt>
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          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
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        <EIN>270712680</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Fort Hamilton Hospital Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>452036966</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>The Fort Hamilton Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Grandview Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>405 W Grand Avenue</AddressLine1Txt>
          <CityNm>Dayton</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45405</ZIPCd>
        </USAddress>
        <EIN>311649591</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Greene Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>310886949</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Greene Memorial Hospital</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Greene Memorial Hospital</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>310809436</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(1)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Greene Oaks</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>310999724</EIN>
        <PrimaryActivitiesTxt>Senior Healthcare Facilities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(2)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Kettering Affiliated Health Services Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
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          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>311051688</EIN>
        <PrimaryActivitiesTxt>Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Affiliated Health Services Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>311127485</EIN>
        <PrimaryActivitiesTxt>Health Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Independent Medical Group</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>272649285</EIN>
        <PrimaryActivitiesTxt>Health Services</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
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        </USAddress>
        <EIN>310621866</EIN>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Medical Center Foundation</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>237419897</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Network Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>832687866</EIN>
        <PrimaryActivitiesTxt>Administrative Support Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>The Fort Hamilton Hospital</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>310536662</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Grandview Associates</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>311427280</EIN>
        <PrimaryActivitiesTxt>Building Management</PrimaryActivitiesTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Dayton Osteopathic Hospital</BusinessNameLine1Txt>
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        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
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        <GeneralOrManagingPartnerInd>1</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.92000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Southview Orthopedic Center Management Company LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1997 Miamisburg-Centerville Rd</AddressLine1Txt>
          <CityNm>Dayton</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45459</ZIPCd>
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        <EIN>262040203</EIN>
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        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
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        <ShareOfEOYAssetsAmt>3501935</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>1</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.51000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Kettcor</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>311078381</EIN>
        <PrimaryActivitiesTxt>Health Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <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>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Grandview Foundation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>940676</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Alliance Physicians Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>2041708</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>90599</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Network Services</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>35153</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Beavercreek Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>306878</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>-105661</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Alliance Physicians Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Grandview Foundation</BusinessNameLine1Txt>
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        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
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        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Network Services</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Network Services</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Network Services</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Network Services</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>0</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>25631291</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Kettering Medical Center and Kettering Network Services are conduits through which revenue is received and expenses are paid.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>