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      <MissionDesc>WE ARE INSPIRED BY THE LOVE OF CHRIST TO PROVIDE QUALITY HEALTH CARE IN WAYS WHICH RESPECT THE GOD-GIVEN DIGNITY OF EACH PERSON AND THE SACREDNESS OF HUMAN LIFE.</MissionDesc>
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      <Desc>St. Mary's Medical Center was established in 1924 and, based on the core values of compassion, hospitality, reverence, trust, interdependence, and stewardship, continues to provide high quality healthcare services to residents of Huntington, West Virginia and the surrounding area. Services are provided without regard to the patient's race, creed, sex, national origin, age, or handicap. Furthermore, while reimbursement for care provided is crucial to the continued operation of St. Mary's Medical Center, it is recognized that circumstances exist which render certain parties unable to pay for needed services, and no patient is denied services due to the lack of ability to pay. During the fiscal year which ended September 30, 2018, St. Mary's Medical Center provided 97,304 days of inpatient days of care and treated AN additional 277,794 patients in the emergency and outpatient settings. Approximately 78.1% of the inpatients serviced were covered by governmental programs, such as Medicare and Medicaid. A similar percentage is applicable to outpatient services. Since care provided to Medicare and Medicaid beneficiaries is subject to contractual reimbursement restrictions, payment received for services provided is often significantly below the actual cost of the services. St. Mary's Medical Center has established charity care policies and guidelines, used to help identify those patients who genuinely do have the resources to pay for services received. During the fiscal year ended September 30, 2018, the hospital provided approximately $2.5 million dollars in charity care services, representing care provided at reduced prices or completely free of charge. These services include inpatient services, an adult outpatient clinic, a handicapped children's clinic, and a specialty pregnancy clinic. Also, St. Mary's Medical Center exceeds the guidelines established for the West Virginia ad valorem statute.</Desc>
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        <Desc>In addition to those patients without the wherewithal to pay for services rendered, we assist in the relief of burden of government for several programs. A strong auxiliary (operated as a department of the hospital) exists, which contributes heavily to the activities of SMMC. During the fiscal year ended September 30, 2018, the auxiliary contributed approximately $400,000 to SMMC and SMMC awarded grants to various organizations in the amount of $253,800. In addition, volunteers provided over 25,399 hours of service valuable to promoting the mission and activities of the hospital.</Desc>
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        <Desc>St. Mary's has sponsored a number of community building activities during the past year that promote wellness and help enrich the lives of people in the Tri-State. Some of these are as follows: Kids in Motion Kids In Motion is a fun and innovative exercise and nutrition program designed to improve the health of Tri-State area children. It began as a new program in early 2013 as a joint initiative with the Huntington YMCA and other community health partners with everyone working together to fight childhood obesity. It is the only program of its kind in West Virginia. At the heart of the program is Kid Fit, a 10-week program to get kids ages 5-14 moving and having fun, while also learing about fitness and nutrition. Weight, body mass index, body fat percentage and blood pressure are tracked throughout the program to measure progress and to customize the program to fit each child. During Kid Fit, children utilize exer-gaming equipment, which combines video games and exercise. Parents are also encouraged to participate and entire families are losing weight and getting healthier because of the program. St. Mary's has committed tremendous financial resources to providing equipment and staff and St. Mary's provided the key leadership role in planning and development of the program. Several local families are already providing testimony about how Kids in Motion has helped them. Total Woman Program St. Mary's Women's Health Program has 5000+ members and thousands more are reached with wellness activities and programs held every month of the year. The Total Woman provides free health information and screenings and a chance for members to ask questions of health providers. The coordinator of the program helps women schedule their appointments to fit busy schedules. A magazine is published twice a year with important health information and sent to all members. Fitness Events The annual St. Mary's Tri-State Triathlon was held in August and includes three separate races - a triathlon, triathlon relay and duathlon. The triathlon consists of a half-mile swim, 15-mile bike ride and 2.9-mile loop run. In the duathlon, the swim course is replaced by a 2.9-mile loop run in the opposite direction of the previous loop. Races use computer-chip timing. The event averages 200+ participants each year but it has a wider reaching impact of promoting fitness in the community with news coverage of stories about first time participants and their ability to complete a triathlon. Many family and friends also gather at the event as spectators and some are inspired to compete in the next year's event (www.healthtristate.org). St. Mary's partnered with the same organization for the Marshall/St.Mary's Marathon with more than 2000 participants in November with a Marathon, half marathon and 5-K at the Joan C. Edwards Stadium at Marshall University. Girls On The Run of Cabell and Wayne Counties Girls on the Run of Cabell and Wayne County is a nonprofit organization dedicated to creating a world where every girl knows and activates her limitless potential and is free to boldly pursue her dreams. Girls on the Run inspires girls to recognize their inner strength and celebrate what makes them one of a kind. Trained coaches lead small teams through our research-based curricula which includes dynamic discussions, activities and running games. Over the course of the ten-week program, girls in 3rd-8th grade develop essential skills to help them navigate their worlds and establish a lifetime appreciation for health and fitness. St. Mary's support of $11,500 covers the program expenses as well as a part-time coordinator for the area. American Heart Association Heart Walk and Go Red for Women Luncheon St. Mary's has been the main sponsor for the Heart Walk each year in April. As one of St. Mary's major service lines, the Regional Heart Institute promotes healthy heart activities for the public throughout the year. The Heart Walk and the Go Red Luncheon for Women are two of our main events. The Heart Walk generates team building by raising funds for the American Heart Association, ending with the actual walk at Ritter Park. St. Mary's employee teams are joined by teams all across Cabell and Wayne Counties both raising funds for heart research and supporting walking as a family heart-healthy activity. EXCESS OF 800+ people participant each year for the walk. The cause receives wider exposure through advertising heart healthy education tips and information (www.heart.org). Colors for a Cure 5k St. Mary's is the major sponsor for this 5/k run/walk in September that raises close to 60,000 per year. A majority of the proceeds pay for mammograms for uninsured and underinsured women in the Tri-State as well as other cancer treatment programs at St. Mary's Regional Cancer Center. Community Health Screenings Additionally St. Mary's participates in numerous health fairs throughout the year. They provide screenings for health issues such as cholesterol, blood sugar, HDL, osteoporosis, etc. at no charge. Also, education about various health issues such as stroke risk, joint replacement surgery, and other health risk factors are provided. There are 1000+ people screened each year through free screenings (www.st-marys.org). Other Events to Encourage Fitness St. Mary's also sponsored many other races and walks that promoted wellness and fitness and those include the Ridge to River 10 mile trail run in June, the St. Mary's Veteran's Memorial Day 5K run in May in Ironton, Ohio, the St. Mary's/Barboursville Lion's Club 5K in March. School Programs to Encourage Fitness St. Mary's partners with more than 20 local schools to encourage kids to participate in the Mileage Plus fitness program. St. Mary's certified fitness trainer visits schools and works with a program coordinator at each school to set up programs where students track the number of steps they take each day and St. Mary's provides T-shirts and incentive prizes to encourage kids to walk each day at school as part of an organized program. Volunteer Service on Community Boards St. Mary's managers volunteer their time with service on a number of community non-profit boards including the following: Lawrence County(Ohio) Economic Development Corporation, Lawrence County (Ohio) Chamber of Commerce, Greater Huntington Regional Chamber of Commerce, United Way of the River Cities, the Huntington Museum of Art, AND the Foundation for the Tri-State Community and Society of Yeager Scholars at Marshall University. Go-Nood1e Interactive St. Mary's partners with Go-Noodle to provide interactive online teaching tools to thousands of school children in several local counties. The program gets kids moving with physical and mental exercises in the classroom as they learn through fun and interactive video sessions. St. Mary's partners with several local businesses to provide the enhanced version of Go-Noodle that allows teachers to incorporate the activities into their curriculum.</Desc>
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      <Form990PartVIISectionAGrp>
        <PersonNm>VICKIE SMITH</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MATT MILLER</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL G SELLARDS</PersonNm>
        <TitleTxt>PRESIDENT/CEO</TitleTxt>
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        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>1106316</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24416</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ANGELA D SWEARINGEN</PersonNm>
        <TitleTxt>VICE PRESIDENT/CFO</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>TODD CAMPBELL</PersonNm>
        <TitleTxt>SR. VICE PRESIDENT/COO</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>VERA ROSE MD</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN BETH ROBINSON</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY PARNELL</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERNEST TAYLOR MD</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ELIZABETH BOSLEY DNP RN</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>NEPAL CHOWDHURY MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW WERTHAMMER MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DWIGHT SAULLE MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>GEOFFREY COUSINS MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>PANOS IGNATIADIS MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>UNIVERSITY PHYSICIANS AND SURGEONS</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1600 MEDICAL CENTER DRIVE SUITE B5</AddressLine1Txt>
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            <StateAbbreviationCd>WV</StateAbbreviationCd>
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        </ContractorAddress>
        <ServicesDesc>MEDICAL</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>CERNER HEALTH SERVICES INC</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 959168</AddressLine1Txt>
            <CityNm>ST LOUIS</CityNm>
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            <ZIPCd>63195</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>INFO TECHNOLOGY</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>NORTHSTAR ANESTHESIA</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6225 NORTH STATE HIGHWAY 161</AddressLine1Txt>
            <CityNm>IRVING</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75038</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>ULTIMATE HEALTH SERVICES</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5170 US ROUTE 60 EAST</AddressLine1Txt>
            <CityNm>HUNTINGTON</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25705</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL</ServicesDesc>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>AMERICAN RED CROSS</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4 CHASE METROTECH CENTER 7TH FLOOR</AddressLine1Txt>
            <CityNm>BROOKLYN</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>11245</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL</ServicesDesc>
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      <NoncashContributionsAmt>407364</NoncashContributionsAmt>
      <TotalContributionsAmt>23901366</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>411607780</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>411607780</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SCHOOL OF NURSING</Desc>
        <BusinessCd>611600</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>1884552</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PURCHASE REBATES</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>2454554</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>1336608</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>OTHER PROGRAM SERVICE REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>339810</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>339810</RelatedOrExemptFuncIncomeAmt>
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      <RoyaltiesRevenueGrp>
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        <RealAmt>1499854</RealAmt>
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      <NetRentalIncomeOrLossGrp>
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        <RelatedOrExemptFuncIncomeAmt>1261496</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueMiscGrp>
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      <OtherRevenueMiscGrp>
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        <ManagementAndGeneralAmt>1516034</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>1428971</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>360000</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>13032652</ProgramServicesAmt>
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        <ProgramServicesAmt>4290624</ProgramServicesAmt>
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        <ProgramServicesAmt>105114</ProgramServicesAmt>
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      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>1826907</ProgramServicesAmt>
        <ManagementAndGeneralAmt>859721</ManagementAndGeneralAmt>
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      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>14364057</TotalAmt>
        <ProgramServicesAmt>9767559</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4596498</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>1730354</TotalAmt>
        <ProgramServicesAmt>1176641</ProgramServicesAmt>
        <ManagementAndGeneralAmt>553713</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>78576007</TotalAmt>
        <ProgramServicesAmt>78576007</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBTS</Desc>
        <TotalAmt>23002546</TotalAmt>
        <ProgramServicesAmt>23002546</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>10537290</TotalAmt>
        <ProgramServicesAmt>7165357</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3371933</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PROVIDER TAX</Desc>
        <TotalAmt>10831766</TotalAmt>
        <ProgramServicesAmt>10831766</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>2191295</TotalAmt>
        <ProgramServicesAmt>1490081</ProgramServicesAmt>
        <ManagementAndGeneralAmt>701214</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>420293886</TotalAmt>
        <ProgramServicesAmt>326429393</ProgramServicesAmt>
        <ManagementAndGeneralAmt>93864493</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1031119</BOYAmt>
        <EOYAmt>1023025</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>16975608</BOYAmt>
        <EOYAmt>13017363</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>84816950</BOYAmt>
        <EOYAmt>74574476</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>9597401</BOYAmt>
        <EOYAmt>10827279</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>3328582</BOYAmt>
        <EOYAmt>3874218</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>203901462</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>6850410</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>144146352</BOYAmt>
        <EOYAmt>197051052</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>90474384</BOYAmt>
        <EOYAmt>87859331</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>16024245</BOYAmt>
        <EOYAmt>4325236</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>3164221</BOYAmt>
        <EOYAmt>5177595</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>369558862</BOYAmt>
        <EOYAmt>397729575</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>44343388</BOYAmt>
        <EOYAmt>52483234</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>910907</BOYAmt>
        <EOYAmt>968806</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>75522589</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>139340063</BOYAmt>
        <EOYAmt>196204718</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>260116947</BOYAmt>
        <EOYAmt>249656758</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>105469820</BOYAmt>
        <EOYAmt>144100747</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>3972095</BOYAmt>
        <EOYAmt>3972070</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PermanentlyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>109441915</BOYAmt>
        <EOYAmt>148072817</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>369558862</BOYAmt>
        <EOYAmt>397729575</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>23411449</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>699701</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>14519752</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" />
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbyingGrp />
      <TotalDirectLobbyingGrp />
      <TotalLobbyingExpendGrp />
      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <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>94492</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>94492</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IIB, Line 1, Lobbying Activities:</FormAndLineReferenceDesc>
        <ExplanationTxt>PART II-B, LINE 1, LOBBYING ACTIVITIES: The Hospital is a member of the West Virginia Hospital Association (WVHA), The Catholic Health Association of the United States (CHA), and the American Hospital Association (AHA), which engage in lobbying on behalf of its members. A portion of the dues paid to WVHA, CHA, and AHA have been allocated to lobbying activities which totaled $94,492. Specific information regarding the advocacy agendas of the associations can be viewed on their websites, WVHA.org, CHAUSA.org, and AHA.org</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp>
        <OtherCostOrOtherBasisAmt>9390000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>9390000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>152873370</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2851065</DepreciationAmt>
        <BookValueAmt>150022305</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp />
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>37225449</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3959995</DepreciationAmt>
        <BookValueAmt>33265454</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>4412643</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>39350</DepreciationAmt>
        <BookValueAmt>4373293</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>197051052</TotalBookValueLandBuildingsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED PENSION COSTS</Desc>
        <Amt>116429812</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED SALARIES AND WAGES</Desc>
        <Amt>4167341</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>GENERAL RESERVES</Desc>
        <Amt>7485000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATE HOSPITAL</Desc>
        <Amt>67747633</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>THIRD PARTY PAYOR SETTLEMENT</Desc>
        <Amt>374932</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>196204718</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT ANNUALLY REVIEWS ITS TAX PROVISIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS AT SEPTEMBER 30, 2018 AND 2017.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent100Ind>X</Percent100Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent200DInd>X</Percent200DInd>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>false</ExpensesExceedBudgetInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <PersonsServedCnt>5096</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>759906</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>759906</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00190</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <PersonsServedCnt>30675</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>78805022</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>66154388</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>12650634</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03180</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <TotalFinancialAssistanceTyp>
        <PersonsServedCnt>35771</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>79564928</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>66154388</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>13410540</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03370</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <ActivitiesOrProgramsCnt>2</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>796</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>5255</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>5255</NetCommunityBenefitExpnsAmt>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <ActivitiesOrProgramsCnt>4</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>60</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>9722174</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>4828667</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4893507</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01230</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <CashAndInKindContributionsGrp>
        <ActivitiesOrProgramsCnt>3</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>645</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>375207</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>375207</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00090</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <ActivitiesOrProgramsCnt>9</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>1501</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>10102636</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>4828667</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>5273969</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01320</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <ActivitiesOrProgramsCnt>9</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>37272</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>89667564</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>70983055</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>18684509</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04690</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <CommunitySupportGrp>
        <ActivitiesOrProgramsCnt>11</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>916</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>4545</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>4545</NetCommunityBenefitExpnsAmt>
      </CommunitySupportGrp>
      <HealthImprovementAdvocacyGrp>
        <ActivitiesOrProgramsCnt>10</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>1846</PersonsServedCnt>
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        <NetCommunityBenefitExpnsAmt>15167</NetCommunityBenefitExpnsAmt>
      </HealthImprovementAdvocacyGrp>
      <TotalCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>21</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>2762</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>19712</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>19712</NetCommunityBenefitExpnsAmt>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>6945892</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>1389178</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>105726738</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>105643784</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>82954</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <OtherInd>X</OtherInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>HUNTINGTON AREA MRI</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>PROVIDE MRI SCANS</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.49</OrgProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.51</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>THREE GABLES SURGERY</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>OUTPATIENT HEALTH CARE</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.5234</OrgProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.4756</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>ST MARY'S MEDICAL CENTER INC</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>2900 FIRST AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGTON</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25702</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <ResearchFacilityInd>X</ResearchFacilityInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <EmergencyRoomOtherInd>X</EmergencyRoomOtherInd>
        <OtherDesc>URGENT CARE</OtherDesc>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>ST MARY'S MEDICAL CENTER</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>false</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>true</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>15</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>false</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>See Part VI Supplemental Information</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>15</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>See Part VI Supplemental Information</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>200.</FPGFamilyIncmLmtDscntCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>SEE PART V, PAGE 8</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>SEE PART V, PAGE 8</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>SEE PART V, PAGE 8</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section A: This facility includes a school of nursing, school of respiratory therapy, a school of medical imaging and a clinical pastoral education program. Interns and residents from Marshall University School of Medicine are also assigned at the hospital for their clinical rotations as are students in community based Practical nursing programs. St. Mary's Medical Center: Part V, Section B, Line 5: In conducting the Community Health Needs Assessment for St. Mary's Medical Ctr., the medical center took into account input from representatives of the community served by the medical center, including those with special knowledge of or expertise in public health. The CHNA was done in collaboration with Cabell Huntington Hospital and the local health department of the service areas identified. A third party specialist, the Center for Entrepreneurial Studies and Development,Inc. located in Morgantown, WV was engaged to assist in the planning and development process. SMMC established a core planning team consisting of representative members of the medical center management: Director of Provider Relations, VP of Mission Integration, Sr. VP &amp; COO, VP of Support Services, Planning &amp; Development, and the VP of Finance &amp; CFO. St. Mary's Medical Center: Part V, Section B, Line 11: The SMMC action plan focused upon three overarching goals: building a network of collaboration, enhancing education and awareness activities, and tailoring interventions for specific demographic groups with an emphasis on senior awareness. Each priority was evaluated to determine if SMMC currently was addressing that need, able to adapt current programs or develop new programs to meet the need, provide an agency that is currently addressing the needed financial support, or if there were insufficient resources (financial or personal) to address the need without collaboration with other agencies. Priorities that were deemed to be outside the scope of SMMC and addressed by other resources in the community were not included in the action plan. St. Mary's Medical Center Part V, line 16a, FAP website: https://www.st-maryscdn.net/pdfs/FAP_Policy_FY2018.pdf St. Mary's Medical Center Part V, line 16b, FAP Application website: https:/www.st-maryscdn.net/pdfs/financial_assistance_application.pdf ST. Mary's Medical Center Part V, line 16c, FAP Plain Language Summary Website: http://www.st-marys.org/patients-and-visitors/billing/</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>7</FacilityNum>
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        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>ST MARY'S FAMILY CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1 CHATEAU LANE</AddressLine1Txt>
            <CityNm>BARBOURSVILLE</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25504</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>ST MARY'S FAMILY CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>147 WILLOW TREE WAY</AddressLine1Txt>
            <CityNm>HURRICANE</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25526</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>ST MARY'S FAMILY CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>6475 FARMDALE ROAD</AddressLine1Txt>
            <CityNm>BARBOURSVILLE</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25504</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>ST MARY'S WOMEN'S &amp; FAMILY CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>143 PEYTON STREET</AddressLine1Txt>
            <CityNm>BARBOURSVILLE</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25504</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>ST MARY'S URGENT CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2815 5TH AVENUE</AddressLine1Txt>
            <CityNm>HUNTINGTON</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25702</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>ST MARY'S PAIN RELIEF SPECIALISTS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2900 1ST AVENUE SUITE 210</AddressLine1Txt>
            <CityNm>HUNTINGTON</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25702</ZIPCd>
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          <FacilityTxt>OUTPATIENT CLINIC</FacilityTxt>
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          <BusinessName>
            <BusinessNameLine1Txt>OCCUPATIONAL MEDICINE</BusinessNameLine1Txt>
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            <AddressLine1Txt>2833 FIFTH AVENUE</AddressLine1Txt>
            <CityNm>HUNTINGTON</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25702</ZIPCd>
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          <FacilityTxt>OUTPATIENT CLINIC</FacilityTxt>
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        <FormAndLineReferenceDesc>SCHEDULE H PART VI</FormAndLineReferenceDesc>
        <ExplanationTxt>Part I, Line 3c: Eligibility is determined by comparing household family income against the income poverty guidelines for financial indigence; a ratio of total medical expenses to annual disposable income for medical indigence. Income is defined as the total annual cash receipts before taxes from all sources. Financially indigent. Uncompensated care shall include unreimbursed services to the financially indigent. Financially indigent shall mean uninsured or underinsured patients accepted for care with no obligation or a discounted obligation to pay for services rendered based on the medical center's eligibility system which may include: (a) income levels and means testing or other criteria for determining a patient's inability to pay; or b) other criteria for determining a patient's inability to pay that are consistent with the medical center's mission and established policy. The federal poverty level shall serve as an index for the threshold below which patients receiving care at St. Mary's Medical Center are deemed financially indigent. Financially indigent services include noncovered services for patients eligible for the Medicaid program, services provided under county indigent care contracts, and other state or federal assistance programs for low income groups. Medically indigent. Uncompensated care shall include unreimbursed services to the medically indigent. Medically indigent shall mean patients who are responsible for their living expenses, but whose medical and hospital bills, after payment by third party payers, where applicable, exceed: (a) a specified percentage of the patient's annual gross income (i.e., catastrophic medical expenses) in accordance with the Medical Center's formal eligibility system in such instances where payment would require liquidation of assets critical to living or earning a living; or (b) the criteria for determining a patient's inability to pay. While financial indigence is based strictly on an income level, medical indigence considers both income and the financial obligation for healthcare services to calculate the patient's ability to pay without liquidating assets critical to living or earning a living, such as a home, car, personal belongings, etc. Therefore, patients are considered for medically indigent status on a case by case basis. The patient would be required to provide documentation of income to determine if he/she is to be considered medically indigent. All patients are eligible to be considered for medically indigent status with the exception of patients with income below 200% of the federal poverty level as these patients are considered for some level of uncompensated care under the financially indigent category. Part I, Line 6a: SMMC prepares an annual written report that describes programs and services that promote the health of our community. The Community Benefit Report provides valuable information on programs and services provided by the Medical Center. The report is distributed to Hospital board members but it has not been distributed to the general public. The report is compiled using the program "A Guide for Planning and Reporting Community Benefit." Part I, Line 7: The cost to charge ratio as calculated from worksheet 2 of the Schedule H instructions was used to determine community benefit expenses for financial assistance at cost and Medicaid. The amount of cash and in-kind contributions for community groups was obtained from the hospital's accounting records. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25(A), but subtracted for purposes of calculating the percentage in this column is $23,002,546. Part II, Community Building Activities: St. Mary's has sponsored a number of community building activities during the past year that promote wellness and help enrich the lives of people in the Tri-State. Some of these are as follows: AARP HUNTINGTON CHAPTER ST MARY'S IS THE FOUNDInG SPONSOR OF THIS CHAPTER THAT MEETS MONTHLY AT ST. MARY'S MEDICAL CENTER. ST. MARY'S PROVIDES LEADERSHIP SUPPORT AND FUNDING TO HELP PROVIDE SENIORS WITH USEFUL LIFESTYLE AND HEALTH INFORMATION. American Heart Association Heart Walk and Go Red for Women Luncheon St. Mary's has been the main sponsor for the Heart Walk each year in April. As one of St. Mary's major service lines, the Regional Heart Institute promotes healthy heart activities for the public throughout the year, but the Heart Walk and the Go Red Luncheon for Women are two of our main events. The Heart Walk generates team building by raising funds for the American Heart Association, ending with the actual walk at Ritter Park. St. Mary's employee teams are joined by teams all across Cabell and Wayne Counties both raising funds for heart research and supporting walking as a family heart-healthy activity. Excess of 800+ people participate each year for the walk. The cause receives wider exposure through advertising heart healthy education tips and information (www.heart.org). Community Health Screenings Additionally St. Mary's participates in numerous health fairs throughout the year. The events help provide screenings for health issues such as cholesterol, blood sugar, HDL, osteoporosis, etc. at no charge. Also, education about various health issues such as stroke risk, joint replacement surgery, and other health risk factors are provided. There are 1000+ people screened each year through free screenings (www.st-marys.org). CONCERT FOR A CURE ST. MARY'S FOUNDATION AND ST. MARY'S REGIONAL CANCER CENTER ARE SPONSORS OF THIS EVENT TO RAISE MONEY FOR CANCER AWARENESS. A MAJORITY OF THE PROCEEDS PAY FOR MAMMOGRAMS FOR UNINSURED AND UNDERINSURED WOMEN IN THE TRI-STATE AS WELL AS OTHER CANCER TREATMENT PROGRAMS AT ST. MARY'S REGIONAL CANCER CENTER. ST. MARY'S ALSO SUPPORTS THE AMERICAN CANCER SOCIETY AT THE ANNUAL RELAY OF LIFE EVENT AT RITTER PARK IN HUNTINGTON. Fitness Events ST. MARY'S PARTNERS WITH HEALTHYTRISTATE.ORG TO OFFER THE MARSHALL/ST. MARY'S MARATHON/HALF-MARATHON AND 5K EACH YEAR WITH MORE THAN 2000 PARTICIPANTS. THE EVENT IS HELD EACH NOVEMBER AT THE JOAN C. EDWARDS STADIUM AT MARSHALL UNIVERSITY AND ENCOURAGES THE COMMUNITY TO SET FITNESS GOALS TO PREPARE FOR THIS EVENT. ST. MARY'S ALSO PARTNERS WITH COMMUNITY LEADERS IN IRONTON, OHIO TO OFFER THE ST. MARY'S VETERAN'S MEMORIAL DAY 5-K, WITH 500+ PARTICIPANTS EACH YEAR. ST. MARY'S IS ALSO NOW PART OF THE GREATER HUNTINGTON WALKS INITIATIVE, ENCOURAGING PEOPLE TO WALK DAILY AND TRACK THEIR STEPS. THE FIRST GOAL WAS TO COLLECTIVELY WALK TO THE MOON AND BACK AND THAT GOAL WAS ACHIEVED WELL BEFORE THE DEADLINE. Girls On The Run of Cabell and Wayne Counties Girls on the Run of Cabell and Wayne County is a nonprofit organization dedicated to creating a world where every girl knows and activates her limitless potential and is free to boldly pursue her dreams. Girls on the Run inspires girls to recognize their inner strength and celebrate what makes them one of a kind. Trained coaches lead small teams through our research-based curricula which includes dynamic discussions, activities, and running games. Over the course of the ten-week program, girls in 3rd-8th grade develop essential skills to help them navigate their worlds and establish a lifetime appreciation for health and fitness. St. Mary's FINANCIAL support covers the program expenses as well as a part-time coordinator for the area. GoNoodle Interactive St. Mary's partners with GoNoodle to provide interactive online teaching tools to thousands of schoolchildren in several local counties. The program gets kids moving with physical and mental exercises in the classroom as they learn through fun and interactive video sessions. St. Mary's partners with several local businesses to provide the enhanced version of GoNoodle that allows teachers to incorporate the activities into their curriculum. PROACT ST. MARY'S PARTNERS WITH CABELL HUNTINGTON HOSPITAL, VALLEY HEALTH AND MARSHALL HEALTH TO OPERATE THIS DAY TREATMENT CENTER FOR OPIOID AND OTHER DRUG ADDICTS. A WIDE RANGE OF TREATMENT OPTIONS ARE OFFERED AND SUPERVISED BY PHYSICIANS AND NURSES. ST. MARY'S PROVIDES LEADERSHIP AND FINANCIAL SUPPORT. REGIONAL HEALTH SUMMIT ST. MARY'S PARTNERS WITH CABELL HUNTINGTON HOSPITAL EACH YEAR TO STAGE A REGIONAL HEALTH SUMMIT TO DISCUSS THE REGION'S MOST PRESSING ISSUES. MORE THAN 100 HEALTH ORGAIZATIONS ARE REPRESENTED EACH YEAR AT THIS GATHERING. ST. MARY'S PROVIDES LEADERSHIP AND FINANCIAL SUPPORT. Total Woman Program St. Mary's Women's Health Program has 5000+ members and thousands more are reached with wellness activities and programs held every month of the year. The Total Woman provides free health information and screenings and a chance for members to ask questions of health providers. The coordinator of the program helps women schedule their appointments to fit busy schedules. Volunteer Service on Community Boards St. Mary's managers volunteer their time with service on a number of community non-p</ExplanationTxt>
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        <USAddress>
          <AddressLine1Txt>1448 TENTH AVE SUITE 100</AddressLine1Txt>
          <CityNm>HTGN</CityNm>
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        <RecipientEIN>550745033</RecipientEIN>
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      <RecipientTable>
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          <BusinessNameLine1Txt>MARSHALL UNIVERSITY FOUNDATION</BusinessNameLine1Txt>
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          <AddressLine1Txt>ONE JOHN MARSHALL DRIVE</AddressLine1Txt>
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      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL G SELLARDS</PersonNm>
        <TitleTxt>PRESIDENT/CEO</TitleTxt>
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        <BonusRelatedOrganizationsAmt>442916</BonusRelatedOrganizationsAmt>
        <DeferredCompRltdOrgsAmt>8100</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>16316</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>1130732</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANGELA D SWEARINGEN</PersonNm>
        <TitleTxt>VICE PRESIDENT/CFO</TitleTxt>
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        <BonusRelatedOrganizationsAmt>134909</BonusRelatedOrganizationsAmt>
        <DeferredCompRltdOrgsAmt>8100</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>22637</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>565835</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TODD CAMPBELL</PersonNm>
        <TitleTxt>SR. VICE PRESIDENT/COO</TitleTxt>
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        <BonusRelatedOrganizationsAmt>172488</BonusRelatedOrganizationsAmt>
        <DeferredCompRltdOrgsAmt>8100</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>22637</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>705003</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>VERA ROSE MD</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>293281</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23510</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>324891</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUSAN BETH ROBINSON</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>245044</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>32120</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23475</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>308739</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TIMOTHY PARNELL</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>229627</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>35252</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>7946</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16884</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>289709</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERNEST TAYLOR MD</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>377301</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>61002</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9135</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>455538</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ELIZABETH BOSLEY DNP RN</PersonNm>
        <TitleTxt>VICE-PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>241580</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>27942</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8086</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23288</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>300896</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NEPAL CHOWDHURY MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>1000000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1361068</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>24386</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>2393554</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW WERTHAMMER MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>500000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>928379</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22334</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1458813</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DWIGHT SAULLE MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>600000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>712881</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22080</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1343061</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GEOFFREY COUSINS MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>850000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>492924</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22146</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1373170</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PANOS IGNATIADIS MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>500000</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>594556</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>8100</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>21600</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1124256</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>ON A REGULAR BASIS, THE ORGANIZATION PROVIDES DOCUMENTATION TO THE COMPENSATION COMMITTEE OF THE PALLOTTINE HEALTH SERVICES, INC. BOARD WITH RESPECT TO THE COMPENSATION OF THE ORGANIZATION'S CEO FOR REVIEW AND APPROVAL. SUCH INFORMATION INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX-EXEMPT ORGANIZATIONS IN THE HUNTINGTON, WEST VIRGINIA COMMUNITY AS WELL AS COMPENSATION FOR THE CEO POSITION WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS, AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE OFFICERS/EXECUTIVE COMMITTEE IS DOCUMENTED.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
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      <ArtFractionalInterestGrp />
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      <CollectiblesGrp />
      <FoodInventoryGrp />
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>407364</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <TaxidermyGrp />
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      <ScientificSpecimensGrp />
      <ArchaeologicalArtifactsGrp />
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
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    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>IN MAY 2018, CABELL HUNTINGTON HOSPITAL, INC. BECAME THE SOLE MEMBER OF ST. MARY'S MEDICAL CENTER, A FULL SERVICE ACUTE CARE HOSPITAL LOCATED IN HUNTINGTON, WEST VIRGINIA. AT THAT TIME, MOUNTAIN HEALTH NETWORK, INC. (MHN) BEGAN PROVIDING MANAGEMENT SERVICES TO CABELL HUNTINGTON HOSPITAL, INC. AS WELL AS ST. MARY'S MEDICAL CENTER. MHN IS COMPRISED OF EXPERIENCED HEALTH CARE PROFESSIONALS, PERSONS WITH EXTENSIVE FINANCIAL AND BUSINESS EXPERTISE, CLINICIANS WITH EXTENSIVE MEDICAL EXPERIENCE AND EXPERIENCED HOSPITAL BOARD MEMBERS. MHN WILL BE RETAINED TO FORMULATE AND IMPLEMENT APPROPRIATE MEASURES FOR THE INTEGRATION OF CERTAIN PROGRAMS AND SERVICES AT BOTH HOSPITALS AS WELL AS PROVIDED CONTINUED MANAGEMENT, STRATEGIC PLANNING AND OPERATIONAL SUPERVISION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization is a membership (not a stock) corporation under West Virginia state law. Effective May 1, 2018, under agreement, the organization's sole corporate member was transferred to Cabell Huntington Hospital, Inc., a related not-for-profit organization from the previous sole corporate member, Pallottine Health Services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>Effective May 1, 2018, in accordance with the terms and requirements of its governing documents (i.e. bylaws), on an annual basis, the organization's current board members recommend the list of candidates for membership to the governing body for the subsequent term to the Cabell Huntington Hospital, Inc. board of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>As a result of the ownership change effective May 1, 2018 Cabell Huntington Hospital, Inc., as the sole corporate member, also has the right to approve or ratify significant decisions of the organization's governing body including the amendment of bylaws and charters, removal of members of the governing body, and the decision to dissolve the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is reviewed by the organization's management in consultation with an independent accounting firm. The financial review is based on the organization's audited financial statements for the relevant time period. The CFO will review the 990 with the finance/audit committee and the board of directors at the next scheduled board meeting in August.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C:</FormAndLineReferenceDesc>
        <ExplanationTxt>Upon employment and annually thereafter each key employee and officer of the organization is required to complete a conflict of interest and disclosure form, providing sufficient information about his/her personal interests and relationships so the organization can (1) determine whether any potential or actual conflicts of interest may exist, and (2) monitor work or service assignments to avoid placing the key employee, officer or director in a position where there may be an appearance, potential or actual, of a conflict of interest or a question of objectivity. The completed conflicts of interest and disclosure forms for directors are returned to the organization. In the event that any board member is deemed to lack independence or a conflict of interest exists, he/she is required to leave the room and cannot be part of the discussion or vote.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15:</FormAndLineReferenceDesc>
        <ExplanationTxt>On an annual basis, the organization provides documentation to the executive compensation committee of the St. Mary's Medical Center, Inc. board of directors for evaluation of compensation of the organization's officers and key employees for review and approval. Such information includes comparable data from similar size tax-exempt organizations in the Huntington, West Virginia community as well as compensation for these positions (as disclosed on form 990) with other organizations in the health care industry that are of similar size, demographics, and geography. Review and approval of the compensation arrangement by the officers/executive committee is documented.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request at its office at 2900 First Avenue, Huntington, WV 25702. A nominal fee is charged if copies are requested.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 16B</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization has adopted a formal written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements. However, the normal due diligence process for analyzing any such arrangements undertaken in conjunction with the organization's external legal counsel, accountants and other business advisers does include a review to determine the following: 1) the impact of the arrangement under applicable federal and state law 2) whether the arrangement will jeopardize the organization's exempt status as a Section 501(c)(3) charitable organization-hospital. 3) whether the arrangement will result in any unrelated business taxable income 4) the impact of the arrangement on any existing contractual agreements or other business relationships and 5) whether the arrangement will result in any conflicts of interest. If there are any concerns with respect to any of the above matters, the organization will take appropriate steps to ensure that, if the joint venture is pursued, the arrangement will be in compliance with applicable federal and state law and to safeguard the organization's tax-exempt status. A formal written policy and procedure has been approved.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS</FormAndLineReferenceDesc>
        <ExplanationTxt>Transfers to/from Affiliates, net $ 1,474,806 Changes in pension fund status 13,044,946 Total $14,519,752</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCE/AUDIT COMMITTEE SHALL REVIEW THE RESULTS OF THE ANNUAL AUDIT AND ALL OTHER REPORTS FROM INDEPENDENT EXTERNAL AUDITORS AND SHALL ARRANGE FOR THOSE REPORTS, TOGETHER WITH ANY RECOMMENDATIONS FROM THE FINANCE/AUDIT COMMITTEE, TO BE PRESENTED TO THE BOARD OF DIRECTORS AT SUCH A TIME AS THE BOARD OF DIRECTORS MAY SCHEDULE FOR THAT PURPOSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:COLLECTION SERVICES TOTAL FEES:1285588</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:MEDICAL SERVICES TOTAL FEES:3681007</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:OTHER CONTRACT SERVICES TOTAL FEES:1937719</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:20937487</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:17539202</ExplanationTxt>
      </SupplementalInformationDetail>
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          <BusinessNameLine1Txt>ST MARY'S MEDICAL MANAGEMENT LLC</BusinessNameLine1Txt>
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          <AddressLine1Txt>2900 FIRST AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGTON</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <PrimaryActivitiesTxt>MED PRACTICE</PrimaryActivitiesTxt>
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        <EndOfYearAssetsAmt>16670975</EndOfYearAssetsAmt>
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          <BusinessNameLine1Txt>SMMC</BusinessNameLine1Txt>
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        <EndOfYearAssetsAmt>485903</EndOfYearAssetsAmt>
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          <BusinessNameLine1Txt>PALLOTINE HEALTH SERVICES</BusinessNameLine1Txt>
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          <AddressLine1Txt>2900 FIRST AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGTON</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25702</ZIPCd>
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        <EIN>550688201</EIN>
        <PrimaryActivitiesTxt>PRIOR PARENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12a, I</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>PALLOTTINE MISSIONARY SISTERS</BusinessNameLine1Txt>
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          <AddressLine1Txt>2900 FIRST AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGTON</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25702</ZIPCd>
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        <EIN>431783315</EIN>
        <PrimaryActivitiesTxt>CHURCH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>ST MARY'S MEDICAL CENTER FOUNDATION</BusinessNameLine1Txt>
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          <AddressLine1Txt>2900 FIRST AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGTON</CityNm>
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          <ZIPCd>25702</ZIPCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>LINE 12b,II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SMMC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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          <BusinessNameLine1Txt>TRI STATE MRI</BusinessNameLine1Txt>
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          <AddressLine1Txt>2900 FIRST AVE</AddressLine1Txt>
          <CityNm>HTGN</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <PrimaryActivitiesTxt>MEDICAL SERVI</PrimaryActivitiesTxt>
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          <AddressLine1Txt>200 MALL RD</AddressLine1Txt>
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          <ZIPCd>41101</ZIPCd>
        </USAddress>
        <EIN>311517507</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVI</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
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        <ShareOfEOYAssetsAmt>576713</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.25000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HUNTINGTON AREA MRI</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2900 FIRST AVE</AddressLine1Txt>
          <CityNm>HTGN</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25702</ZIPCd>
        </USAddress>
        <EIN>261877332</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVI</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>248878</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>163025</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>true</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.49000</OwnershipPct>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>IRONTON MED CAMPUS</BusinessNameLine1Txt>
        </RelatedOrganizationName>
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          <AddressLine1Txt>1408 CAMPBELL DR</AddressLine1Txt>
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        </USAddress>
        <EIN>471141289</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>180007</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>7931890</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.65000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>IRONTON MED CAMPUS</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1408 CAMPBELL DR</AddressLine1Txt>
          <CityNm>IRONTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45638</ZIPCd>
        </USAddress>
        <EIN>471637912</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>205026</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>1938223</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.65000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>THREE GABLES SURGERY</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>5897 ST RTE 7</AddressLine1Txt>
          <CityNm>PROCTORVILLE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45669</ZIPCd>
        </USAddress>
        <EIN>870648900</EIN>
        <PrimaryActivitiesTxt>OUTPATIENT CA</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
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        <ShareOfEOYAssetsAmt>6258178</ShareOfEOYAssetsAmt>
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        <GeneralOrManagingPartnerInd>true</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.52340</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>TRI-STATE MPSLLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2900 FIRST AVE</AddressLine1Txt>
          <CityNm>HTGN</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25702</ZIPCd>
        </USAddress>
        <EIN>824513003</EIN>
        <PrimaryActivitiesTxt>BILLINGS/COLLECT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>RELATED</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>-20748</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>68867</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.60000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>VANGUARD FINANCIAL SERVICES</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2900 FIRST AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGTON</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25702</ZIPCd>
        </USAddress>
        <EIN>450496141</EIN>
        <PrimaryActivitiesTxt>COLLECTION AG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ST MARYS MED</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C CORP</EntityTypeTxt>
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        <ShareOfEOYAssetsAmt>978891</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MOUNTAIN HEALTH NETWORK INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 636</AddressLine1Txt>
          <CityNm>HUNTINGTON</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25711</ZIPCd>
        </USAddress>
        <EIN>320573122</EIN>
        <PrimaryActivitiesTxt>MANAGEMENT SVCS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C CORP</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <OwnershipPct>0.00000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>true</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>HUNTINGTON AREA MRI SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>F</TransactionTypeTxt>
        <InvolvedAmt>220500</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>HUNTINGTON AREA MRI SERVICES</BusinessNameLine1Txt>
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        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>177420</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ST MARY'S MEDICAL CENTER FOUNDATION</BusinessNameLine1Txt>
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        <TransactionTypeTxt>b</TransactionTypeTxt>
        <InvolvedAmt>4295</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ST MARY'S MEDICAL CENTER FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>c</TransactionTypeTxt>
        <InvolvedAmt>407363</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ST MARY'S MEDICAL CENTER FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>241626</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>CLAIRE FRANCES HEALTH CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>15000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>THREE GABLES SURGERY CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
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        <InvolvedAmt>347354</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>THREE GABLES SURGERY CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>173678</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>THREE GABLES SURGERY CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>33496</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>THREE GABLES SURGERY CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>477932</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>INTERNAL ACCTG</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>