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      <Form990PartVIISectionAGrp>
        <BusinessName>
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        <BusinessName>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>MARK G ROGERS</BusinessNameLine1Txt>
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        <BusinessName>
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      <ContractorCompensationGrp>
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        <ExplanationTxt>Facility , 1 - Genesis Medical Center Aledo. Genesis Health System Business Intelligence conducted a comprehensive Community Health Needs Assessment in 2017 along with receiving valuable input from following community representatives: Genesis Ambulance American Red Cross Genesis Medical Center, Aledo Mercer Country Crisis Center Genesis Senior Living, Aledo Mercer County School System Genesis Health Group, Aledo Brookstone of Aledo Advanced Rehab &amp; Sports Medicine Mercer County YMCA Mercer County Health Department University of Illinois Extension Sherrard School System Eagle View Health Community Health Aledo Rehab and Healthcare As part of this CHNA, GMC - Aledo partnered with the Mercer County Public Health Department and sought input from public health representatives and other community stakeholders with an interest in the health of the community through a series of discussion meetings. Organizations and sectors represented at these community stakeholder meetings include: Private Sector: Business Owners and Representatives Voluntary Sector: Ministerial and Non-Profit Service Agencies Informal Sector: Foundation and Daycare Policy Partners: Law Enforcement, Board of Health and 708 Board Health practitioners: Home Health, Public Health, Assisted Living, Long-term Care, Primary Care, Pharmacy, Dental Care and Hospital Care Beneficiaries: Insurance, Emergency Services, Coroner Resource Partners: Search and Rescue, Extension Office Public Sector: Schools and County Board An important component to these meetings was a discussion of the primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups. This qualitative input was used to further inform the prioritization process described later in this summary.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - GENESIS MEDICAL CENTER, ALEDO:. With following the Genesis Medical Center Aledo's mission along with coordinating with the Quad City Health Initiative Implementation plan, Genesis Medical Center Aledo will be focusing and delivering on the following programs and resources to address the needs of the community: A. Oral Health 1. Assist and support Mercer County Health Department who leads this initiative 2. Raised funds to refurbish "tooth mobile" a mobile dental facility 3. Enhance relationship with Eagle View FQHC B. Nutrition, Physical Activity, and Weight 1. Healthbeat Exercise equipment at Yogi Bear Park, Aledo 2. Sponsor of Rhubarb Run 2016, 2017, 2018 3. Genesis Medical Center, Aledo employee membership at YMCA 4. Farmer's Market weekly 5. 275 participants in Metabolic Syndrome Program with Genesis Philanthropy-41% of participants have reduced their risk for Met S 6. U of I Extension offers weekly fruit and vegetable tasting at Farmer's Market and offered numerous nutrition education programs 7. Partnered with YMCA for Livestrong, Diabetes Prevention, Just Lose It, and Enhanced Fitness C. Mental Health and Substance Abuse 1. Mental Health summit held, which moved to the Mercer County Mental Health working group with 3 subgroups: Resource Directory, Support Groups, Collaborative Grant Writing. Group meets quarterly. 2. Secured additional funding through HRSA for Mental Health Action Plan of $600,00 for 3 years 3. Increased access to mental health services at GHG Aledo, adding two mental health care providers. D. Access to Health Care 1. Added Advanced Practitioner to GHG Aledo 2. Increased specialty providers in Urology and Pain Management 3. Enhanced relationship with Eagle View FQHC 4. Utilizing traditional and social media to make residents aware of health services</ExplanationTxt>
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            <BusinessNameLine1Txt>GENESIS HEALTH GROUP ALEDO</BusinessNameLine1Txt>
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            <AddressLine1Txt>1007 NW 3RD STREET</AddressLine1Txt>
            <CityNm>ALEDO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>61231</ZIPCd>
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          <FacilityTxt>OUTPATIENT PHYSICIAN CLINIC</FacilityTxt>
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            <BusinessNameLine1Txt>GENESIS HEALTH GROUP ALPHA</BusinessNameLine1Txt>
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            <AddressLine1Txt>202 PICARD STREET BOX 419</AddressLine1Txt>
            <CityNm>ALPHA</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>61413</ZIPCd>
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          <FacilityTxt>OUTPATIENT PHYSICIAN CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>GENESIS MEDICAL CENTER, ALEDO (GMC, ALEDO) UTILIZED WORKSHEET 2 TO CALCULATE ITS COST-TO-CHARGE RATIO. THE CALCULATED COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID. COSTS OF THE "OTHER BENEFITS" REPORTED IN 7E -7I WERE COMPILED THROUGHOUT THE YEAR IN THE COMMUNITY BENEFIT DATABASE (I.E., CBISA) THAT GMC, ALEDO UTILIZES. No bad debt expense was included in the denominator because bad debt was reported in line 2f of Part VIII, Statement of Revenue. The organization's total community benefit expense as a percentage of total expenses is 21.14% and the percentage increase to 53.53% if Medicare cost report allowable costs are included in total community benefit expense.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 6a Community benefit report prepared by related organization</FormAndLineReferenceDesc>
        <ExplanationTxt>GENESIS HEALTH SYSTEM (GHS IOWA), GENESIS HEALTH SYSTEM (GHS ILLINOIS)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7g Subsidized Health Services</FormAndLineReferenceDesc>
        <ExplanationTxt>No costs associated with a physician clinic were reported in subsidized health services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>Genesis Medical Center Aledo (GMC Aledo) utilized worksheet 2 to calculate its cost-to charge ratio. The calculated cost-to-charge ratio was used to calculate the cost of charity care and unreimbursed Medicaid. Costs of the "other benefits" report in 7e-7i were complied throughout the year in the community benefit database (I.E., CBISA) that GMC Aledo utilizes.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part II Community Building Activities</FormAndLineReferenceDesc>
        <ExplanationTxt>Economic Development (F2): Council and Chamber - Genesis Medical Center Aledo supports employee involvement on local council and chamber committees. Grants to Community Businesses - Genesis Medical Center Aledo supports its community by giving grants to local businesses to improve economic development and relieve or reduce the burden of government or other tax-exempt organizations. Community Support (F3): GMC, Aledo supports employee involvement with disaster readiness for the community. Coalition Building(F6): Genesis Medical Center Aledo supports its employee involvement as hospital representatives to health coalitions. Advocacy for community health improvements/safety (F7): GMC Aledo supports employee involvement with Illinois Hospital Association meetings. Workforce Development (F8): GMC, Aledo supports its employee involvement on the Rock Island, Henry and Mercer Counties Workforce Development Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount</FormAndLineReferenceDesc>
        <ExplanationTxt>In accordance with Healthcare Financial Management Association Statement No. 15, Bad Debt is reported at the full-established charge from the most recent audited financial report. Payments received after an account has been written off to bad debt were credited to a bad debt recovery account. Discounts on patient accounts provided by third-party payers were written off to a contractual allowance account.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 3 Bad Debt Expense Methodology</FormAndLineReferenceDesc>
        <ExplanationTxt>GMC, Aledo utilizes Avadyne Health to process aging patient accounts. Avadyne Health's collection process utilizes publicly available information to ensure all aging patient accounts receive financial assistance in accordance to GMC, Aledo policy before being deemed bad debt. GMC, Aledo reported zero dollars for the estimated amount of the organization's bad debt attributable to patients eligible under the organization's financial assistance policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>Patient receivables due directly from the patients are carried at the original charge for the service provided less amounts covered by third-party payors and less an estimated allowance for doubtful receivables based on a review of all outstanding amounts on a monthly basis. Receivables due from medical office building tenants and from commercial laundry customers are carried at the original invoice amount less an estimate made for doubtful accounts. Management determines the allowance for doubtful accounts by identifying troubled accounts, by historical experience applied to an aging of accounts, and by considering the patient's financial history, credit history and current economic conditions. GMC, Aledo does not charge interest on patient receivables. Receivables are written off as bad debts when deemed uncollectible. Recoveries of receivables previously written off are recorded as a reduction of bad debt expense when received. Page 19 of financial statements. Page 11 of financial report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 8 Community benefit &amp; methodology for determining medicare costs</FormAndLineReferenceDesc>
        <ExplanationTxt>The Medicare cost report was used to determine the amount reported in part III, lines 5, 6, and 7 for the hospital. No Medicare shortfalls were included in community benefit. The Medicare cost report shortfall represents the difference between the total revenue received from Medicare based on Medicare cost report reimbursement rates and the costs incurred by GMC, Aledo in providing healthcare services to the elderly. The total Medicare shortfall, which includes fee screen services, was $191,106. In accordance with GMC, Aledo's mission statement, "To Provide Compassionate, Quality Health Services to All Those in Need," the elderly were served despite the total Medicare loss of $191,106. GMC, Aledo has a clear mission to serve all those in need and to improve the health of the community including the elderly. Furthermore, there are no for-profit hospitals in the community, and therefore GMC, Aledo is the only healthcare organization in the community who provides access to healthcare for Medicare patients. Accordingly, it is GMC, Aledo's position for the reasons stated above that the total Medicare shortfall of $191,106 represents a Community Benefit. Pursuant to the instructions to the Form 990, Schedule H, the Medicare shortfall is not included in Part I, line 7. If the total Medicare shortfall was included in Part I, line 7, then Part I, line 7k, Column f would be 9.12%.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>Every effort is made to determine a patient's eligibility for financial assistance. If eligible, payment plans are made available based on their resources and income. All balances owing after financial assistance allowances have been taken are payable in monthly payments in accordance with the organization's financial assistance policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16a FAP website</FormAndLineReferenceDesc>
        <ExplanationTxt>- GENESIS MEDICAL CENTER, ALEDO: Line 16a URL: http://www.genesishealth.com;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16b FAP Application website</FormAndLineReferenceDesc>
        <ExplanationTxt>- GENESIS MEDICAL CENTER, ALEDO: Line 16b URL: http://www.genesishealth.com;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16c FAP plain language summary website</FormAndLineReferenceDesc>
        <ExplanationTxt>- GENESIS MEDICAL CENTER, ALEDO: Line 16c URL: http://www.genesishealth.com;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2 Needs assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>To complete this CHNA, existing health-related data was collected via the online Community Commons Community Health Needs Assessment report tool at http://www.communitycommons.org/maps-data. This site allows for identification of 87 distinct health and social indicators at the county level, along with comparisons to state and national data, and Healthy People 2020 Targets, where available. Once an indicator report was generated, relevant indicators were reviewed to determine how Mercer County compared to available state/national data. See the "Detailed Health Indicators" section of this document. Genesis Health System Business Intelligence conducted a comprehensive Community Health Needs Assessment in 2017 along with receiving valuable input from following community representatives: Genesis Ambulance American Red Cross Genesis Medical Center, Aledo Mercer Country Crisis Center Genesis Senior Living, Aledo Mercer County School System Genesis Health Group, Aledo Brookstone of Aledo Advanced Rehab &amp; Sports Medicine Mercer County YMCA Mercer County Health Department University of Illinois Extension Sherrard School System Eagle View Health Community Health Aledo Rehab and Healthcare As part of this CHNA, GMC - Aledo partnered with the Mercer County Public Health Department and sought input from public health representatives and other community stakeholders with an interest in the health of the community through a series of discussion meetings. Organizations and sectors represented at these community stakeholder meetings include: Private Sector: Business Owners and Representatives Voluntary Sector: Ministerial and Non-Profit Service Agencies Informal Sector: Foundation and Daycare Policy Partners: Law Enforcement, Board of Health and 708 Board Health practitioners: Home Health, Public Health, Assisted Living, Long-term Care, Primary Care, Pharmacy, Dental Care and Hospital Care Beneficiaries: Insurance, Emergency Services, Coroner Resource Partners: Search and Rescue, Extension Office Public Sector: Schools and County Board An important component to these meetings was a discussion of the primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups. This qualitative input was used to further inform the prioritization process described later in this summary.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3 Patient education of eligibility for assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>Information on the availability of financial assistance is posted in visible locations in the admission department of the hospital. In addition, the hospital registration staff makes available informative brochures for patients in the Emergency Room registration area explaining their eligibility for assistance. GMC, Aledo provides a patient financial counselor to discuss options with the patients. Patient Financial Services prepares and provides a letter to each patient, explaining their current balance and advising them of their options. A phone number is provided with the letter encouraging the patient to call if needed. In addition, the GMC, Aledo website www.genesishealth.com also lists the options for payment.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4 Community information</FormAndLineReferenceDesc>
        <ExplanationTxt>The mission of Genesis Health System, EIN 36-3616314, sole member of GMC, Aledo, is to provide compassionate, quality health services to all those in need. GMC, Aledo and its related organizations live its mission each and every day by serving a 10-county region of Eastern Iowa and Western Illinois, including both urban and rural areas. Mercer County is a county located in the state of Illinois. According to 2017 CHNA report, it has a population of 16,107, which is a decrease of 5.01% from 16,957 in 2000. Its county seat is Aledo. It is one of the four counties that make up the Davenport-Moline-Rock Island Metropolitan Statistical Area. In the 2017 CHNA report via U.S. census Bureau American Community Survey 2011-15 and U.S. Census 2010, total population of 16,107 showed 3,655, or 22.24% lived in urban setting with 12,779 lived in a rural setting, or 77.76%. In the county the population was spread out with 22.1% under the age of 18, 58.02% from 18 to 64, and 19.88% who were 65 years of age or older. Gender total population shows female at 8,113, or 50.37% of total and male at 7,994, or 49.63% of total. The racial makeup of the county was 97.42% White, 0.47% Black or African American, 0.05% Native American, 0.32% Asian, and 1.74% from other races. According to the US Census Bureau American Community Survey 2011-15, total families of 4,646, 1,889 show an annual income over $75,000, or 40.66% of total.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5 Promotion of community health</FormAndLineReferenceDesc>
        <ExplanationTxt>GMC, Aledo's Board of Directors is a diverse representation of persons who reside in the primary service area that GMC, Aledo and its related organizations serve. GMC, Aledo and its related organizations' executives and employees serve on dozens of volunteer boards throughout the region on important projects and initiatives, such as homeless shelters, mental health, downtown redevelopment, junior achievement, and events and festivals. GMC, Aledo employees serve the communities where they live by serving in elected offices in city and county government. GMC, Aledo extends medical staff privileges to all qualified physicians in its communities. GMC, Aledo provides the community with classes and events promoting health and health education. Residents in the region served by GMC, Aledo learn CPR, First Aid, parenting skills and newborn care by enrolling in classes. GMC, Aledo and its related organizations has reduced its environmental footprint on the communities it serves by implementing bulk waste recycling, Polystyrene recycling, reducing Sharps disposal, implementing water runoff measures, and reducing water and chemical usage in the medical laundry. GMC, Aledo and its related organizations maintains an active effort to advocate for access to health care in Iowa and Illinois state government and in Washington D.C. Employees also participate in a Voter Voice initiative to advocate on important health issues with city, county, state and national elected officials. Surplus funds resulting from efficient operations and cost-containment measures are re-invested in the healthcare operations of GMC, Aledo to improve the healthcare services that GMC, Aledo provides. Advances in medical equipment and technology, staff education, and new medical services are examples of operational investments that ultimately improve the health of the communities that GMC, Aledo serves.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 6 Affiliated health care system</FormAndLineReferenceDesc>
        <ExplanationTxt>Genesis Health System (GHS Iowa), an Iowa nonprofit corporation, and Genesis Health System (GHS Illinois), an Illinois not-for-profit corporation, have identical governing boards, management and bylaws and can act jointly. GHS Iowa is also the sole member of Genesis Health Services Foundation, Genesis Philanthropy, Genesis Accountable Care Organization LLC, and Genesis Health System Workers' Compensation Plan and Trust, the sole stockholder of GenVentures, Inc., a member of Misericordia Assurance Company, Ltd. and a partner in GenGastro, LLC. GHS Illinois is the sole member of Genesis Medical Center, Aledo, and Genesis Senior Living, Aledo, and is a partner in The Larson Center Partnership. GHS Iowa, GHS Illinois, GMC Aledo, and GSL Aledo collectively represent the Obligated Group on certain components of the Obligated Group's long-term debt. GHS Iowa and GHS Illinois operate the following business units: Genesis Health System provides administrative, management, information technology and other support services to its affiliates. Genesis Clinical Services operates physician medical practices, convenient care practices and an occupational medicine clinic and provides behavioral health services to the residents of eastern Iowa and western Illinois. Genesis Medical Center - Davenport (GMC - Davenport) is licensed as a 502-bed acute care hospital which provides services from two hospital facilities located in Davenport, Iowa. Genesis Family Medical Center (GFMC) is a family practice residency training program that operates clinics in Davenport and Blue Grass, Iowa to provide a clinical setting for the residents to treat patients. Genesis Medical Center - DeWitt (GMC - DeWitt) is certified as a critical access hospital, which has 13-acute care and swing beds, and has a 77-bed long-term care facility, which provides services from its facility in DeWitt, Iowa. Genesis Visiting Nurse Association and Hospice (VNA) provide home health care, community nursing services and hospice services to patients in eastern Iowa and western Illinois. Genesis Medical Center - Silvis is licensed as a 145-bed acute care hospital, which provides services from its facility in Silvis, Illinois. Illini Hospital Nursing Home (INH) operates Illini Restorative Care Center and Crosstown Square. Illini Restorative Care Center is a 120-bed licensed nursing facility, consisting of 92 skilled care beds and 28 sheltered care beds. All 92 beds are dually licenses for Medicare/Medicaid services. The sheltered care unit provides rehabilitative and personal care in a family-oriented setting. Crosstown Square is an independent living facility containing 64 rentable apartments and three guest rooms that offers services designed to meet the needs of senior adults. GHS Iowa and GHS Illinois have a controlling ownership interest or membership in the following organizations: Genesis Medical Center Aledo (GMC Aledo) is certified as a critical access hospital, which has 22-acute care and swing beads, as well as a physician clinic, which provides services from its facility in Aledo, Illinois. Genesis Senior Living Aledo (GSL Aledo) is certified as a nursing facility, which has a 92 bed long-term care facility, which provides services from its facility in Aledo, Illinois. Genesis Health Services Foundation (Genesis Foundation) is an organization whose mission is to develop, manage and grant charitable support to meet the health-related needs of the communities served by Genesis Health System. GenGastro, LLC (d/b/a the Center for Digestive Health) is a limited liability company, which operates a single-specialty gastroenterology ambulatory surgery center located in Bettendorf, Iowa. Genesis Health System Maintains a 75 percent ownership interest in GenGastro, LLC. The Larson Center Partnership (LCP) is a for-profit real estate partnership which owns a medical office building adjacent to GMC - Illini and leases space for clinics, laboratory, pharmacy and offices to GMC - Illini and other third-party organizations. GHS Illinois is a general partner and owns approximately 79.8% of LCP. GenVentures, Inc. (GenVentures) is a wholly-owned for-profit corporation which operates the following divisions, primarily in the Quad Cities: Genesis at Home, Continuing Care sells and leases home medical equipment; provides intravenous therapy services, including sales of related solutions and supplies to patients; and provides retail pharmaceutical and over-the-counter products to patients and employees of the System. GenProperties owns, leases and/or manages office space in 14 medical office buildings located in Bettendorf, Clinton, Davenport, Eldridge, Le Claire and Muscatine, Iowa. Crescent Laundry provides commercial laundry services to health care facilities in eastern Iowa and in north-central Illinois. Genesis Accountable Care Organization, LLC (Genesis ACO) is an Iowa limited liability company formed in December 2011. Its purpose is to engage in any lawful business and any business related to creation and organization of a "physician-driven" network to act as, and/or participate in, an Accountable Care Organization within the meaning of the federal Patient Protection and Affordable Care Act. The company is also organized to develop a clinically integrated network of providers including physicians, health professionals, hospitals and ancillary providers working together to promote high quality, coordinated and efficient care to patients including members of various managed care payors and the community at large. Genesis Health System Workers' Compensation Plan and Trust (Workers' Compensation Trust) provides a fund, which can be used to pay workers' compensation claims and costs for the benefit of Genesis Health System. Misericordia Assurance Company, Ltd. (Misericordia) is a wholly-owned Cayman based captive insurance company which underwrites the general and professional liability risks of Genesis Health System and affiliates. Genesis Philanthropy is a wholly-owned tax-exempt entity formed in 2013, which will partner with other hospital foundations to form a regional network to attract donors to help fund specific health-related causes and promote wellness in the region.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 7 State filing of community benefit report</FormAndLineReferenceDesc>
        <ExplanationTxt>IL, IA</ExplanationTxt>
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        <TitleTxt>FORMER CHIEF COMPLIANCE RISK OFFICER</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>211512</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>42645</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>755</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>4500</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>16379</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>275791</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>PAUL BOLLINGER</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>V.P. LEGAL AFFAIRS/ASST SECRETARY</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>241588</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>47847</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>67535</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>16065</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>373035</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>MARK G ROGERS</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>V.P. FINANCE/CFO GHS/ASST TREASURER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>417002</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>27828</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>576989</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>7250</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>20444</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1049513</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>195507</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>NIDAL HARB</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>454136</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>81359</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>256108</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>6000</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>19851</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>817454</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>JACQUELINE K ANHALT</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>V.P. PATIENT SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>242856</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>33179</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>64281</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>9709</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>19254</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>369279</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>KENNETH R CROKEN</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>V.P. CORPORATE COMMUNICATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>259413</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>34438</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>69397</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>11902</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>15105</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>390255</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>ROBERT W FRIEDEN</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>V.P. INFORMATION SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>270450</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>41883</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>91640</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>9563</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>19434</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>432970</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>HEIDI S KAHLY-MCMAHON</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>V.P. HUMAN RESOURCES</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>266121</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>48745</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>69324</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>3634</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>19426</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>407250</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>MIKE L SHARP</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>V.P. SUPPORT SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>183035</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>40861</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>83351</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>25308</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>13158</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>345713</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>GENESIS MEDICAL CENTER, ALEDO RELIES ON GENESIS HEALTH SYSTEM (GHS IOWA) TO DETERMINE THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS, AND KEY EMPLOYEES. GHS IOWA UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE SUCH COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part II, Column (F)</FormAndLineReferenceDesc>
        <ExplanationTxt>The following individuals also participated in or continue to have a supplemental executive retirement savings benefit in 2013, 2014, 2015, 2016, and 2017 sponsored by Genesis Health System (GHS IA), a related organization: Douglas P. Cropper-$334,500 and Mark Rogers-$195,507. The dollar amount represents prior contributions made by GHS IA on behalf of the individuals to the plan in 2013, 2014, 2015, 2016, and 2017. This information included in deferred compensation on the prior years' form 990, Part VII and Schedule J, Part II. The individual reached a specified level of vesting in 2017, so the dollar amount is now included in reportable compensation on the current year form 990, part VII and Schedule J, Part II.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>The following individuals participated in a supplemental ROTH indexed universal life(IUL) plan in 2017 sponsored by Genesis health System (GHS IA), a related organization: Robert W. Frieden- $63,443, Jacqueline Anhalt-$43,822, Heidi S. Kahly-McMahon- $48,059, Paul Bollinger- $38,933, and Nidal Harb-$83,752. The dollar amount represents the current year contribution made by GHS IA on behalf of the individuals to the plan in 2017. This information is included in reportable compensation on the form 990, Part VII and Schedule J, Part II. The following individuals participated in a supplemental executive retirement savings benefit plan in 2017 sponsored by Genesis health System (GHS IA), a related organization: Kenneth R. Croken- $66,227, Mark G. Rogers- $133,573, and Mike L. Sharp-$44,932. The dollar amount represents the current year contribution made by GHS IA on behalf of the individuals to the plan in 2017. This information is included in reportable compensation on the form 990, Part VII and Schedule J, Part II. Split-dollar life insurance participants are Douglas P. Cropper-established in 2016 and sponsored by Genesis Health System(GHS IA), a related organization. GHS IA deposited funds into life insurance policies on the participant's life. During life, and subject to the policies generating sufficient values, the participant can borrow from one of the policies. The borrowing is monitored and limited so the policies do not lapse. At the participant's death, the organization recovers premiums plus interest plus additional key-person insurance proceeds. There were no loans or contributions in 2017.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="17005876" softwareVersionNum="2017v2.2">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>EDWARD (TED) J ROGALSKI</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Edward (Ted) J. Rogalski is the son of Edward J. Rogalski, PH.D.; director of GMC, Aledo.</RelationshipDescriptionTxt>
        <TransactionAmt>165195</TransactionAmt>
        <TransactionDesc>EDWARD (TED) J. ROGALSKI RECEIVES COMPENSATION FROM GENESIS MEDICAL CENTER, ALEDO AS AN ADMINISTRATOR OF THE ORGANIZATION.</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>GENVENTURES INC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Mark Rogers, Roger Hill, James Koehler, and Mike Sharp are officers of GenVentures Board</RelationshipDescriptionTxt>
        <TransactionAmt>297314</TransactionAmt>
        <TransactionDesc>GENESIS MEDICAL CENTER, ALEDO PAID GENVENTURES, INC. FOR LAUNDRY SERVICES.</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>GENVENTURES INC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Mark Roger, Roger Hill, James Koehler, and Mike Sharp are officers of GenVentures Board</RelationshipDescriptionTxt>
        <TransactionAmt>1386758</TransactionAmt>
        <TransactionDesc>GENVENTURES, INC. PAID GENESIS MEDICAL CENTER ALEDO FOR PHARMACY SUPPLIES</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="17005876" softwareVersionNum="2017v2.2">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part I, Line 4 and Part VI, Section A, Line 1b</FormAndLineReferenceDesc>
        <ExplanationTxt>The following Genesis Medical Center, Aledo directors are not independent due to transactions disclosed of form 990, Schedule L of Genesis Health System (GHS, Iowa) a related tax-exempt organization: Peter J. Benson, Edmund P. Coyne, Jr. M.D., Mark C. Kilmer, Edwin V. Motto, M.D., and Dale D. Zude.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER OF GENESIS MEDICAL CENTER, ALEDO IS GENESIS HEALTH SYSTEM (GHS ILLINOIS), AN ILLINOIS NONPROFIT CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>AS THE SOLE MEMBER OF GENESIS MEDICAL CENTER, ALEDO (CORPORATION), GENESIS HEALTH SYSTEM (GHS ILLINOIS) HAS THE POWER: 1) TO DETERMINE THE NUMBER OF DIRECTORS OF THE CORPORATION AND TO ELECT, APPOINT, REMOVE, OR FILL THE VACANCIES OF THE BOARD MEMBERS; 2) TO PRESENT AT ANY REGULAR OR SPECIAL BOARD MEETING I) AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS, II) A PLAN OF MERGER OR CONSOLIDATION BY THE CORPORATION INTO OR WITH ANY OTHER CORPORATION, III) A PROPOSAL FOR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE CORPORATION'S ASSETS, AND IV) A PROPOSAL FOR DISSOLUTION OF THE CORPORATION AND PLAN OF DISTRIBUTION; 3) TO ESTABLISH SYSTEM WIDE POLICIES AND PROCEDURES REGARDING QUALITY OF CARE, FINANCE, UTILIZATION OF RESOURCES, MANAGED CARE CONTRACTING, STRATEGIC PLANNING, AND EMPLOYEE BENEFITS; 4) TO ASSESS THE CORPORATION EXPENSES OF THE MEMBER ATTRIBUTABLE TO THE CORPORATION AND AFFILIATES AND TO ASSESS TO THE CORPORATION ITS SHARE OF GENERAL OVERHEAD OF THE MEMBER; AND 5) TO DIRECT THE CORPORATION TO TRANSFER FUNDS TO THE MEMBER FOR THE DEVELOPMENT OF SYSTEM WIDE PROJECTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>Prior to submitting the form 990 to the IRS, it is reviewed at the organization's finance committee meeting, and then it is e-mailed to the organization's board of directors' one week in advance of a scheduled meeting. At the board of directors meeting, internal management reviews the form 990 with the board of directors. Internal management review is also completed of the compiled information and is provided to Executive management; including, but not limited to the vice president, finance/CFO; vice president, legal affairs; and chief compliance risk officer of the organization's corporate member. Suggested changes from all of the reviews are considered for inclusion in the final form 990 submitted to the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>ANY COVERED PERSON, DEFINED AS ANY DIRECTOR, OFFICER, OR MEMBER OF A BOARD OR BOARD COMMITTEE OF GENESIS MEDICAL CENTER, ALEDO (GMC, ALEDO) OR AN AFFILIATE, SHOULD DISCLOSE AN INTEREST OR POTENTIAL INTEREST AS SOON AS THEY BECOME AWARE OF A POTENTIAL TRANSACTION THAT WILL BE CONSIDERED BY MANAGEMENT, THE BOARD, OR A COMMITTEE OF THE BOARD. COVERED PERSONS ARE REQUIRED ANNUALLY TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILY, OR BUSINESS RELATIONSHIPS THAT REASONABLY COULD GIVE RISE TO AN INTEREST OR CONFLICT INVOLVING GMC, ALEDO, OR AN AFFILIATE, OR WITH RESPECT TO DESIGNATED FACILITIES AND ACTIVITIES, AND ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS FAMILIAR WITH AND IS IN COMPLIANCE WITH THE LETTER AND SPIRIT OF THIS POLICY. ANY COVERED PERSON FOUND TO HAVE A CONFLICT OF INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING TO PRESENT INFORMATION AND ADDRESS ANY QUESTIONS RAISED BY OTHER DIRECTORS OR COMMITTEE MEMBERS. SAID PERSON SHALL NOT BE ALLOWED TO ACTIVELY AND AGGRESSIVELY ADVOCATE IN HIS OR HER OWN BEHALF NOR SHALL SUCH PERSON ADVOCATE HIS OR HER POSITION INFORMALLY THROUGH PRIVATE CONTACT, COMMUNICATION, AND DISCUSSION WITH ANOTHER DIRECTOR. AFTER SUCH PRESENTATION, THE PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE APPLICABLE TRANSACTION OR ARRANGEMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH EXECUTIVE POSITION IS EVALUATED USING A FORMAL EVALUATION PLAN THAT IS ESTABLISHED BY AN OUTSIDE CONSULTANT. AT THE PRESENT TIME, THE CONSULTANT USES A POINT SYSTEM FOR JOB EVALUATION. THE POINT VALUES ARE BASED ON "KNOW HOW", "PROBLEM SOLVING", "ACCOUNTABILITY", AND OTHER JOB ATTRIBUTES SPECIFIC TO THE POSITION. ONCE THE POINT VALUE IS SET FOR A POSITION, MARKET COMPARISONS FOR JOBS WITH THE SAME ORGANIZATIONAL IMPACT CAN BE COMPARED FOR SALARY PURPOSES AND ESTABLISH PAY RANGES. THE DESIGN OF THE PAY RANGES FOR EXECUTIVES IS BASED ON MARKET DATA. THE MIDPOINT OF EACH PAY RANGE IS ESTABLISHED AT THE 50TH PERCENTILE OF THE MARKET COMPARISONS. A MINIMUM AND MAXIMUM ARE ESTABLISHED OFF OF THE MIDPOINT. SPECIFIC PAY RATES FOR EXECUTIVES ARE SUBJECT TO CEO AND COMPENSATION COMMITTEE AND THE GENESIS MEDICAL CENTER, ALEDO (GMC, ALEDO) BOARD OF DIRECTORS APPROVAL. PAY RANGES ARE REVIEWED EACH YEAR TO DETERMINE THE NEED FOR REVISION. WHEN MARKET CONDITIONS SUGGEST AN ADJUSTMENT TO PAY RANGES, DATA WILL BE PRESENTED TO THE COMPENSATION COMMITTEE FOR ITS REVIEW. THE SPECIFIC PAY RANGES ARE SUBJECT TO CEO, COMPENSATION COMMITTEE, AND GHS BOARD OF DIRECTOR APPROVAL. THE PRESIDENT AND CEO HAVE THE AUTHORITY AND RESPONSIBILITY TO ESTABLISH AND ADJUST, WITHIN THE RANGE APPROVED BY THE COMPENSATION COMMITTEE AND THE GMC, ALEDO BOARD OF DIRECTORS, THE BASE COMPENSATION OF EACH EXECUTIVE EMPLOYED BY GMC, ALEDO, AT APPROPRAITE TIMES. THE GMC, ALEDO BOARD OF DIRECTORS SHALL ESTABLISH AND ADJUST, WITHIN THE RANGE APPROVED BY THE COMPENSATION COMMITTEE, THE BASE COMPENSATION FOR THE CEO OF GMC, ALEDO, AT APPROPRIATE TIMES. THE LAST TIME THIS PROCESS WAS FORMALLY UNDERTAKEN WAS NOVEMBER 2016.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VII, Section A, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>GENESIS HEALTH SYSTEM (GHS IOWA), GENESIS HEALTH SYSTEM (GHS ILLINOIS), GENESIS SENIOR LIVING, ALEDO, GENESIS HEALTH SERVICES FOUNDATION, GENVENTURES, INC., GENESIS PHILANTHROPY, AND GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST ARE RELATED ORGANIZATIONS OF GENESIS MEDICAL CENTER, ALEDO. THE AMOUNTS REPORTED AS REPORTABLE COMPENSATION FOR THE OFFICERS, KEY EMPLOYEES, AND HIGHLY COMPENSATED EMPLOYEES, UNLESS OTHERWISE NOTED ELSEWHERE IN PART VII, ARE FOR SERVICES RENDERED ON BEHALF OF ALL ORGANIZATIONS. IT WOULD BE ADMINISTRATIVELY IMPRACTICABLE FOR MEMBERS OF THE GOVERNING BOARD AND THE EXECUTIVE TEAM TO BREAKOUT THEIR REPORTABLE COMPENSATION AMONG EACH ORGANIZATION. ALL REPORTABLE COMPENSATION, UNLESS OTHERWISE NOTED IN PART VII, IS PAID BY GHS IOWA.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 2f Other Program Service Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>Contractuals - Total Revenue: -16371004, Related or Exempt Function Revenue: -16371004, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>BLOOD BANK SERVICES: - Total Expense: 21833, Program Service Expense: 21833, Management and General Expenses: , Fundraising Expenses: ; MAINTENANCE SERVICES - Total Expense: 350862, Program Service Expense: 340712, Management and General Expenses: 10150, Fundraising Expenses: ; ENVIRONMENTAL SERVICES - Total Expense: 109071, Program Service Expense: 109071, Management and General Expenses: , Fundraising Expenses: ; NUTRITIONAL SERVICES - Total Expense: 116433, Program Service Expense: 116433, Management and General Expenses: , Fundraising Expenses: ; O/S PHARMACY SERVICES - Total Expense: 19806, Program Service Expense: 19806, Management and General Expenses: , Fundraising Expenses: ; ED SERVICES - Total Expense: 37198, Program Service Expense: 37198, Management and General Expenses: , Fundraising Expenses: ; ED PHYSICIAN SERVICES - Total Expense: 1337683, Program Service Expense: 1337683, Management and General Expenses: , Fundraising Expenses: ; PHYSICAL THERAPY SERVICES - Total Expense: 53480, Program Service Expense: 53480, Management and General Expenses: , Fundraising Expenses: ; LAB SERVICES - Total Expense: 431636, Program Service Expense: 431636, Management and General Expenses: , Fundraising Expenses: ; RADIOLOGY SERVICES - Total Expense: 195273, Program Service Expense: 195273, Management and General Expenses: , Fundraising Expenses: ; ANESTHESIA SERVICES - Total Expense: 323652, Program Service Expense: 323652, Management and General Expenses: , Fundraising Expenses: ; EKG/HOLTER SERVICES - Total Expense: 17435, Program Service Expense: 17435, Management and General Expenses: , Fundraising Expenses: ; OFFICE TEMP SERVICES - Total Expense: 2729, Program Service Expense: , Management and General Expenses: 2729, Fundraising Expenses: ; HEALTHCARE SUPPORT SERVICES - Total Expense: 43953, Program Service Expense: 39013, Management and General Expenses: 4940, Fundraising Expenses: ; OUTSIDE TRANSPORTATION SERVICES - Total Expense: 1304, Program Service Expense: 1304, Management and General Expenses: , Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN INTEREST OF NET ASSETS OF FOUNDATION - -53134;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR.</ExplanationTxt>
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