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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Matthew Watkins</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>040.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>608224</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15993</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John Michalski</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>040.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>666683</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18179</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Michael Myers</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>040.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>566559</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23454</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Christopher O'Neal</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>040.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>515357</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23508</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4116999</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>263639</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>30</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Jarvis Downing and Emch Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 6253</AddressLine1Txt>
            <CityNm>Wheeling</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>26003</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contracting Engineering Services</ServicesDesc>
        <CompensationAmt>937117</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Alliance Healthcare Services</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>100 Bayview Circle</AddressLine1Txt>
            <CityNm>Newport Beach</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>926602983</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Radiology Services</ServicesDesc>
        <CompensationAmt>317790</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Alliance Recruiting Resources</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>900 Rockmead Dr Suite 274</AddressLine1Txt>
            <CityNm>Kingwood</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>77339</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Services</ServicesDesc>
        <CompensationAmt>304844</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Quest Diagnostics of PA</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>875 Greentree Rd</AddressLine1Txt>
            <CityNm>Pittsburgh</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>152203610</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Laboratory Services</ServicesDesc>
        <CompensationAmt>216857</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Tritanium Solutions LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>740 Spirit 40 Park Dr</AddressLine1Txt>
            <CityNm>Chesterfield</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>630051122</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Substance Withdrawal Services</ServicesDesc>
        <CompensationAmt>215000</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>13</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>55000</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>8175</AllOtherContributionsAmt>
      <TotalContributionsAmt>63175</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>52132380</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>52132380</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Tuition</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>90713</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>90713</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Pharmacy Income</Desc>
        <BusinessCd>446110</BusinessCd>
        <TotalRevenueColumnAmt>161991</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>161991</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>52385084</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>403242</TotalRevenueColumnAmt>
        <ExclusionAmt>403242</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>178830</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>178830</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>178830</TotalRevenueColumnAmt>
        <ExclusionAmt>178830</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>611514</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <OtherAmt>611514</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>611514</TotalRevenueColumnAmt>
        <ExclusionAmt>611514</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>Cafeteria Income</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>132629</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>132629</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Cash Discounts</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>41639</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>41639</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Incentive Payments</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>8712</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8712</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>39564</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39564</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>222544</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>53864389</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>52607628</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>1193586</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1192622</TotalAmt>
        <ProgramServicesAmt>276323</ProgramServicesAmt>
        <ManagementAndGeneralAmt>916299</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>23054565</TotalAmt>
        <ProgramServicesAmt>22014598</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1039967</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>552460</TotalAmt>
        <ProgramServicesAmt>507887</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44573</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3182479</TotalAmt>
        <ProgramServicesAmt>3029457</ProgramServicesAmt>
        <ManagementAndGeneralAmt>153022</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1562281</TotalAmt>
        <ProgramServicesAmt>1436236</ProgramServicesAmt>
        <ManagementAndGeneralAmt>126045</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>49972</TotalAmt>
        <ManagementAndGeneralAmt>49972</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>6603</TotalAmt>
        <ProgramServicesAmt>6603</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising></FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>5544423</TotalAmt>
        <ProgramServicesAmt>3556309</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1988114</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>50242</TotalAmt>
        <ManagementAndGeneralAmt>50242</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>2161568</TotalAmt>
        <ProgramServicesAmt>1631782</ProgramServicesAmt>
        <ManagementAndGeneralAmt>529786</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>1332191</TotalAmt>
        <ProgramServicesAmt>771325</ProgramServicesAmt>
        <ManagementAndGeneralAmt>560866</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>109936</TotalAmt>
        <ProgramServicesAmt>96794</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13142</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>469252</TotalAmt>
        <ProgramServicesAmt>271692</ProgramServicesAmt>
        <ManagementAndGeneralAmt>197560</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>2624736</TotalAmt>
        <ProgramServicesAmt>1451410</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1173326</ManagementAndGeneralAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1248106</TotalAmt>
        <ProgramServicesAmt>722641</ProgramServicesAmt>
        <ManagementAndGeneralAmt>525465</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>534416</TotalAmt>
        <ProgramServicesAmt>479993</ProgramServicesAmt>
        <ManagementAndGeneralAmt>54423</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Provision for Doubtful Accounts</Desc>
        <TotalAmt>3490661</TotalAmt>
        <ProgramServicesAmt>3490661</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>6569653</TotalAmt>
        <ProgramServicesAmt>6569653</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Taxes, Licenses Fees</Desc>
        <TotalAmt>1376149</TotalAmt>
        <ProgramServicesAmt>1229265</ProgramServicesAmt>
        <ManagementAndGeneralAmt>146884</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Association Dues</Desc>
        <TotalAmt>36923</TotalAmt>
        <ProgramServicesAmt>2323</ProgramServicesAmt>
        <ManagementAndGeneralAmt>34600</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>843850</TotalAmt>
        <ProgramServicesAmt>273495</ProgramServicesAmt>
        <ManagementAndGeneralAmt>570355</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>55993088</TotalAmt>
        <ProgramServicesAmt>47818447</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8174641</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <InfoInScheduleOPartXInd>X</InfoInScheduleOPartXInd>
      <CashNonInterestBearingGrp>
        <BOYAmt>-16910</BOYAmt>
        <EOYAmt>11064</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1086281</BOYAmt>
        <EOYAmt>1058714</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>5746874</BOYAmt>
        <EOYAmt>1706435</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>783008</BOYAmt>
        <EOYAmt>1362776</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>523672</BOYAmt>
        <EOYAmt>233131</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>16600724</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2892743</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>11474659</BOYAmt>
        <EOYAmt>13707981</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>7759769</BOYAmt>
        <EOYAmt>7446815</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>18750</BOYAmt>
        <EOYAmt>18750</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>27376103</BOYAmt>
        <EOYAmt>25545666</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>8245540</BOYAmt>
        <EOYAmt>7758609</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>5220192</BOYAmt>
        <EOYAmt>11562890</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>7517180</BOYAmt>
        <EOYAmt>6751402</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>20982912</BOYAmt>
        <EOYAmt>26072901</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>4432106</BOYAmt>
        <EOYAmt>-2432786</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>115890</BOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
        <BOYAmt>1845195</BOYAmt>
        <EOYAmt>1905551</EOYAmt>
      </PermanentlyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>6393191</BOYAmt>
        <EOYAmt>-527235</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>27376103</BOYAmt>
        <EOYAmt>25545666</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-2128699</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-622360</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-4169367</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="990A" softwareId="18007340" softwareVersionNum="19.1.1.0">
      <HospitalInd>X</HospitalInd>
      <PublicSupportCY170Pct>0.00000</PublicSupportCY170Pct>
      <PublicSupportCY509Pct>0.00000</PublicSupportCY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="990B" softwareId="18007340" softwareVersionNum="19.1.1.0">
      <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>
    <IRS990ScheduleC documentId="990C" softwareId="18007340" softwareVersionNum="19.1.1.0">
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>6603</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>6603</TotalLobbyingExpendituresAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>II-B 1i</FormAndLineReferenceDesc>
        <ExplanationTxt>This amount is calculated based on information provided by the West Virginia Hospital Association and the American Hospital Association. The American Hospital Association estimates that 22.73 of the 2018 dues were allocated to lobbying expense. The West Virginia Hospital Association estimates that during 2018, 16.84 of the dues paid should be allocated to lobbying expense.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="990D" softwareId="18007340" softwareVersionNum="19.1.1.0">
      <InclEscrowCustodialAcctLiabInd>false</InclEscrowCustodialAcctLiabInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>981566</OtherCostOrOtherBasisAmt>
        <BookValueAmt>981566</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>6196104</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1147548</DepreciationAmt>
        <BookValueAmt>5048556</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>2634496</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>487921</DepreciationAmt>
        <BookValueAmt>2146575</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>4819110</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>892522</DepreciationAmt>
        <BookValueAmt>3926588</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>1969448</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>364752</DepreciationAmt>
        <BookValueAmt>1604696</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>13707981</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>Financial derivatives and other financial products</Desc>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Closely-held equity interests</Desc>
      </OtherSecuritiesGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Federal income taxes</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Leases Payable - Current</Desc>
        <Amt>85225</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Other Current Liabilities</Desc>
        <Amt>18750</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Capitalized Leases Payable - Non Current</Desc>
        <Amt>180140</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Self Insurance Liabilities</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Line of Credit</Desc>
        <Amt>1467287</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Other Non-Current Liabilities</Desc>
        <Amt>5000000</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>6751402</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>49783673</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-590055</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>-3490661</OtherRevenueAmt>
      <RevenueNotReportedAmt>-4080716</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>53864389</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>53864389</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>52502427</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>52502427</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>3490661</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>3490661</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>55993088</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>X 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The annual audit and financial statements of Reynolds Memorial Hospital are prepared on a consolidated basis as a member of the WV United Health System. WVUHS, WVUH, PVH, CCHS, CCMC, CCF, CCPC, University Healthcare, BMC, JMC, UHCF, UHC, USC, UHF, UPC, SJH, SJF, RMH and RMF are tax-exempt organizations and not subject to federal or state income taxes in accordance with Section 501c3 of the Internal Revenue Code. On such basis, they will not incur any liability for income taxes, except for possible unrelated business income. AHS, WVUIS and GHC are organizations subject to federal and/or state income taxes. The System does not have any material uncertain tax positions as of December 31, 2018 and 2017. The System accounts for uncertainty in income taxes using a recognition threshold of more-likely-than not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. The Systems policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XI 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount shown on line 2d consists of 3,490,661 Provision for Doubtful Accounts reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount shown on line 4b consists of 3,490,661 Provision for Doubtful Accounts reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990..</ExplanationTxt>
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      <WrittenPolicyInd>true</WrittenPolicyInd>
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      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
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        <TotalCommunityBenefitExpnsAmt>8667121</TotalCommunityBenefitExpnsAmt>
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        <TotalCommunityBenefitExpnsAmt>8891636</TotalCommunityBenefitExpnsAmt>
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      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
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        <BusinessName>
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        </BusinessName>
        <USAddress>
          <AddressLine1Txt>800 Wheeling Ave</AddressLine1Txt>
          <CityNm>Glen Dale</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26038</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>https//wvumedicine.org/reynolds-memorial/</WebsiteAddressTxt>
        <StateLicenseNum>63</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>a</FacilityReportingGroupCd>
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        <FirstLicensedCYOrPYInd>false</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
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        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <CHNAConductedYr>17</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>false</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>https//wvumedicine.org/ruby-memorial-hospital/about-us/community-health-needs-assessment/</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>17</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>false</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>https//wvumedicine.org/ruby-memorial-hospital/about-us/community-health-needs-assessment/</StrategyWebsiteURLTxt>
        <StrategyAttachedInd referenceDocumentId="">false</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>0000000200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>0000000200.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <OtherCriteriaInd>X</OtherCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
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        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>https//wvumedicine.org/bill-pay/financial-assistance/</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>https//wvumedicine.org/bill-pay/financial-assistance/</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>https//wvumedicine.org/bill-pay/financial-assistance/</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <ProspectiveMedicareMedicaidInd>X</ProspectiveMedicareMedicaidInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>true</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Reynolds Memorial Hospital Line Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The CHNA was prepared by Reynolds Memorial Hospital, Inc. and it focused on its primary service area, Marshall County, WV and to a lesser degree, the surrounding counties of Ohio and Wetzel, West Virginia Belmont, Ohio and Greene, Pennsylvania. Information for this CHNA was obtained from several authoritative sources, as well as interviews with community leaders, and a board survey of the community.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Reynolds Memorial Hospital Line Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>Consistent with the 2014 CHNA the three biggest priority health needs identified in our 2017 CHNA were chronic disease, substance abuse, and cancer. Reynolds Memorial Hospital has taken various actions to assist those who battle with chronic diseases. RMH has employed a cardiologist, is currently developing an oncology center, has implemented a Telestroke program and has introduced a new service for asthma patients. To combat substance abuse, Reynolds Memorial Hospital has partnered with Breakthru to implement a medical drug withdrawal program and with local law enforcement by providing them with biohazard sharps containers for hypodermic needle disposal. RMH has hired three primary care physicians, opened and urgent care and established an additional primary care physician in the area. RMH partnered with Health Net Life to station a life flight helicopter in the county, offered educational materials through the cancer resource center, offered educational programs such as Safety Town for children, provides CPR classes and participates with Partners in Education with two Marshall County Schools.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Reynolds Memorial Hospital Line Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>Several issues were identified as reasons individuals were unable to access care. The inability to pay deductibles and copays, lack of availability of doctors, no insurance and the inability to pay for health care, fear of facing health problems, and transportation were top problems. The prioritization team noted this as an area to be aware of, but it was not deemed a priority for the purpose of this needs assessment. The full assessment and implementation policy can be found online https//wvumedicine.org/reynolds-memorial/wp-content/uploads/sites/25/2018/10/2017-RMH-Final-CHNA.pdf</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Reynolds Memorial Hospital Line Part V, Section B, Line 13b</FormAndLineReferenceDesc>
        <ExplanationTxt>RMH does not offer discounted care to individuals who fail the 200 FPG test for charity care. Self-Pay patients with no third party coverage may be eligible for a 20 self-pay discount if they meet certain requirements defined in our financial assistance policy.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Reynolds Memorial Hospital Line Part V, Section B, Line 24</FormAndLineReferenceDesc>
        <ExplanationTxt>All patients are charged an amount equal to gross charges regardless of payment method. Once FAP eligibility is confirmed, charge amounts are moved to Charity Care and no longer charged to the patient.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>1</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Reynolds Rapid Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>215 North Lafayette Avenue</AddressLine1Txt>
            <CityNm>Moundsville</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>26041</ZIPCd>
          </USAddress>
          <FacilityTxt>Urgent Care</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3c</FormAndLineReferenceDesc>
        <ExplanationTxt>Discounted services, for those over 200 FPG, are determined by evaluating income, assets, and liabilities on a case by case basis. The hospital also offers discounts to self pay patients for prompt payment, and also accepts payment plans over time without charging interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>RMH community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The most recent amounts can be found in the WVU Medicine Annual Report available at the following web address https//wvumedicine.org/wp-content/uploads/2018/07/WVU-Medicine-Annual-Report-2017.pdf.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Total community benefit expense for 2018 is 8,914,584 and is 16.98 of total net expenses. To calculate net expense, provision for doubtful accounts of 3,490,661 was deducted from total expenses of 55,993,088 as shown in Part IX line 25 of the core Form 990, for a net expense of 52,502,427.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>RMH did not report any community building acitivies for 2018.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debt Expense at cost was calculated by multiplying provision for doubtful accounts of 3,490,661 by our cost to charge ratio of 44.77 derived from Worksheet 2 in the IRS Schedule H instructions for a total of 1,562,769.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Estimated bad debt attributable to patients eligible for charity care was calculated by running a report within our patient revenue software of all bad debt account balances greater than 15,000. The total of that report was 18,375 which we then multipled by our cost to charge ratio of 44.77 for a total of 8,226.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The estimated bad debt attributable to patients eligible for charity care of 8,226 should be considered community benefit due to the fact that anyone with outstanding balances of 15,000 or greater usually qualifies as catastrophic if the patient completes the application process. In our charity care policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year. Regardless, that bad debt should be considered community benefit as we provide services to those in need regardless of their ability to pay.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Reynolds Memorial Hospitals financial statements are prepared on a consolidated basis as a member of the WV United Health System. The footnote for Accounts Receivable is as follows Patient accounts receivable are reported at net realizable value. For receivables associated with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions in 2018 or the provision for bad debts in 2017. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters. The System grants credit without collateral to its patients, most of whom are local residents and are insured under third-party payor agreements, primarily with Medicare, Medicaid, and various commercial insurance companies. The System records accounts receivable net of estimated price concessions in 2018 and allowances for bad debts in 2017 and such amounts have historically been within managements expectations. The mix of accounts receivable at December 31, 2018 and 2017, from patients and third-party payors is as follows. For 2018, Medicare 29, Medicaid 18, Blue Cross 24, Commercial/Managed Care/Other 26, Patients 3, Total 100. For 2017, Medicare 29, Medicaid 14, Blue Cross 21, Commercial/Managed Care/Other 32, Patients 4, Total 100.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount reported in Part III Line 6 24,332,530 was calculated using the total Medicare allowable cost from the Medicare cost report, less Medicare reimbursement of direct GME.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Reynolds shortfall, 7,559,573 of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>RMH does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity, the patient will not be sent to bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>With assistance from the WVU School of Public Health, Reynolds Memorial Hospital completed a Community Health Needs Assessment CHNA in 2017. The CHNA can be found here https//wvumedicine.org/reynolds-memorial/wp-content/uploads/sites/25/2018/10/2017-RMH-Final-CHNA.pdf</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The CHNA process for Reynolds Memorial Hospital included the collection and analysis of primary and secondary data. Both public and private organizations, such as faith-based organizations, government agencies, educational systems and health and human services entities were engaged to assess the needs of the community. RMH believes that the health status of a community depends on many factors, including quality of health care, social and economic determinants, individual behaviors, heredity, education and the physical environment.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital employs one resource finding clerk to assist patients in obtaining benefits from Medicare, Medicaid, Vocational Rehab, and other federal and state sources.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Our charity care eligibility guidelines are also listed on our website at https//wvumedicine.org/bill-pay/financial-assistance/.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Reynolds Memorial Hospital RMH defines their community service area as Marshall County. Marshall County, WV is a community of approximately 31,000 people where roughly 15.2 of County residents are living below the poverty line and the unemployment rate is at 5.9. Approximately 7.7 of Marshall County residents do not have any health insurance coverage. Roughly 29 of Marshall Countys population is aged 60 or older, a majority of whom need access to a wide range of health care services. RMHs community service population has high levels of obesity, drug addiction, cancer, diabetes and heart disease. RMH believes that the surrounding counties of Ohio and Wetzel, West Virginia Belmont, Ohio and Greene Pennsylvania are also served to a lesser degree but are not considered to be in the community service area.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>RMH has taken various actions to promote community health within its defined community service area. In an effort to offer more specialty care, RMH has employed a cardiologist and a new oncology center is being developed. RMH has also hired three primary care physicians and opened an urgent care office to make health care services more convenient and readily available. RMH has partnered with HealthNet Life to station a life flight helicopter in Marshall County in an effort to improve critical emergency care.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>RMH is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as a part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional healthcare delivery system in its service areas, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include United Hospital Center in Bridgeport, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Camden-Clark Medical Center in Parkersburg, WV, Potomac Valley Hospital in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, and West Virginia University Hospitals Inc. in Morgantown, WV.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The System also includes the physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp. that operate in conjunction with the System hospitals along with United Summit Center, a behavioral health center located in Clarksburg, WV. In addition to these practices, the System also includes WVUH-East, Inc. and Camden-Clark Health Services which operate as management companies for their respective hospitals. The System also includes University Healthcare Foundation in Martinsburg, WV, United Health Foundation in Clarksburg, WV, Camden-Clark Foundation in Parkersburg, WV, and St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
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      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
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        <TitleTxt>COO</TitleTxt>
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        <NontaxableBenefitsFilingOrgAmt>52</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>244931</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Alex Inclan</PersonNm>
        <TitleTxt>CFO</TitleTxt>
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        <OtherCompensationFilingOrgAmt>49</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>12000</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22251</NontaxableBenefitsFilingOrgAmt>
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        <PersonNm>David Hess</PersonNm>
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        <PersonNm>Mike Ortiz</PersonNm>
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        <PersonNm>Nabiel Alkhouri</PersonNm>
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        <OtherCompensationFilingOrgAmt>621</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23473</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>750061</TotalCompensationFilingOrgAmt>
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        <PersonNm>Matthew Watkins</PersonNm>
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        <OtherCompensationFilingOrgAmt>1499</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>18179</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>684862</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Michael Myers</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <NontaxableBenefitsFilingOrgAmt>23454</NontaxableBenefitsFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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      </RltdOrgOfficerTrstKeyEmplGrp>
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        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>The following individuals received deferred compensation contributions in 2018 David Hess in the amount of 57,949 Alex Inclan in the amount of 12,000 and Robert Mike Ortiz in the amount of 19,369. These amounts were properly recorded in deferred compensation on the Form 990 Schedule J.</ExplanationTxt>
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    </IRS990ScheduleJ>
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        <TransactionDesc>Employment</TransactionDesc>
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      <BusTrInvolveInterestedPrsnGrp>
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          <PersonNm>Katie Inclan</PersonNm>
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        <TransactionDesc>Employment</TransactionDesc>
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      <BusTrInvolveInterestedPrsnGrp>
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        <TransactionDesc>Employment</TransactionDesc>
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          <PersonNm>Ryan Twigg</PersonNm>
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    <IRS990ScheduleO documentId="990O" softwareId="18007340" softwareVersionNum="19.1.1.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The IRS Form 990 is reviewed by the Executive Committee before filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Each Trustee and key employee must annually attest to any potential conflicts of interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>West Virginia United Health System, Inc. has a compensation committee which evaluates compensation of key employees based on independent data. It reviews this data annually.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>A schedule of meetings of the Board of Directors is published at the hospital, and the public is welcome. Financial statements, conflict of interest policies, and other documents are available upon request.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Line 11g consists of the following expenses Consulting Professional fees of 866,350 all of which are considered management and general expenses Contracted Labor of 3,213,165 of which 2,110,901 is considered program service expense and 1,102,264 is considered management and general expenses and Contracted and Professional Med Staff of 1,464,908 of which 1,445,408 is considered program service expense and 19,500 is considered management and general expenses.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part X, Section Sch. B, Line Part I</FormAndLineReferenceDesc>
        <ExplanationTxt>Reynolds Memorial Hospital, Inc. reported a contribution from Benjamin M. Spurr Trust of 611,514 on Schedule B that was not recorded on page 9 as revenue. This contribution is a monthly contribution that is used to fund the Reynolds Memorial Hospital retirement plan. Therefore, this contribution doesnt hit a revenue account but is posted to a balance sheet account Current Investments.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 2a 2b</FormAndLineReferenceDesc>
        <ExplanationTxt>Some employees of Reynolds Memorial Hospital Inc., RMH are paid by West Virginia University Hospitals, Inc WVUH. The related payroll filings are prepared by those entities under common paymaster arrangements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Line 9 consists of 4,871,138 of related organization capitalization, 23,229 change in temporary and permanently restricted net assets, and a 725,000 malpractice liability adjustment. The malpractice adjustment was a related party transfer of medical malpractice liability from the local hospital RMH to the System as part of moving to a self-insured captive insurance plan across the System with these hospitals only paying a premium for coverage under the plan and the medical malpractice liability residing at the System level under the captive insurance entity, Augusta LLC.</ExplanationTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>United Physicians Care Inc</BusinessNameLine1Txt>
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          <CityNm>Shinnston</CityNm>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>West Virginia Health Care Co-Op</BusinessNameLine1Txt>
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        <PublicCharityStatusTxt>12a, I</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>West Virginia United Health System</BusinessNameLine1Txt>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Memorial Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>800 Garfield Ave</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
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        <EIN>311524546</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
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          <AddressLine1Txt>800 Garfield Ave</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
        </USAddress>
        <EIN>550769602</EIN>
        <PrimaryActivitiesTxt>Healthcare Access</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>West Virginia United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 Garfield Ave</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
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        <EIN>550667789</EIN>
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          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Physician Corp</BusinessNameLine1Txt>
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          <AddressLine1Txt>604 Ann Street</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
        </USAddress>
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          <AddressLine1Txt>100 Pin Oak Lane</AddressLine1Txt>
          <CityNm>Keyser</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <EIN>550420956</EIN>
        <PrimaryActivitiesTxt>Patient Care Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>WVU Hospitals Inc</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>St Joseph's Hospital of Buckhannon Inc</BusinessNameLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        </USAddress>
        <EIN>550356996</EIN>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>West Virginia United Health System</BusinessNameLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>West Virginia United Health System</BusinessNameLine1Txt>
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          <AddressLine1Txt>1353 Edwin Miller Blvd</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
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          <BusinessNameLine1Txt>Allied Health Services Inc</BusinessNameLine1Txt>
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          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26507</ZIPCd>
        </USAddress>
        <EIN>550652017</EIN>
        <PrimaryActivitiesTxt>Medical Lab</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>West Virginia United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
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      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>West Virginia United Insurance Services Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>3040 University Ave Suite 3200</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26505</ZIPCd>
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        <EIN>550756055</EIN>
        <PrimaryActivitiesTxt>Provider Network</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>West Virginia United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
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      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>