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      <Form990PartVIISectionAGrp>
        <PersonNm>Connie G Donaldson</PersonNm>
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        <OtherCompensationAmt>20764</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Todd Anderson</PersonNm>
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        <AverageHoursPerWeekRltdOrgRt>50.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>699836</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>89574</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Richard Haas</PersonNm>
        <TitleTxt>Former Director/Officer</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>46.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>544287</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Terri Day</PersonNm>
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        <ReportableCompFromRltdOrgAmt>377078</ReportableCompFromRltdOrgAmt>
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      <ProgramServiceRevenueGrp>
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        <ExclusionAmt>1370152</ExclusionAmt>
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      <TotalRevenueGrp>
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        <UnrelatedBusinessRevenueAmt>139035</UnrelatedBusinessRevenueAmt>
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      <CompCurrentOfcrDirectorsGrp>
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      <PayrollTaxesGrp>
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        <ProgramServicesAmt>7603425</ProgramServicesAmt>
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        <ProgramServicesAmt>1627561</ProgramServicesAmt>
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      <FeesForServicesLegalGrp>
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        <ProgramServicesAmt>349892</ProgramServicesAmt>
        <ManagementAndGeneralAmt>-1098</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ProgramServicesAmt>24500</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9340</ManagementAndGeneralAmt>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>328146</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
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        <ProgramServicesAmt>21638025</ProgramServicesAmt>
        <ManagementAndGeneralAmt>609979</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
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        <ProgramServicesAmt>6933</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4590</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>5087244</ProgramServicesAmt>
        <ManagementAndGeneralAmt>92825</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>975442</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7464</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>3607599</ProgramServicesAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>269472</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7392</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>236288</TotalAmt>
        <ProgramServicesAmt>214207</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22081</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>4031440</ProgramServicesAmt>
        <ManagementAndGeneralAmt>78</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>18983693</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ManagementAndGeneralAmt>2614</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Network Services</Desc>
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        <ProgramServicesAmt>45114385</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5219748</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Physician services</Desc>
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        <ProgramServicesAmt>18940069</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>Cost of goods sold</Desc>
        <TotalAmt>7830195</TotalAmt>
        <ProgramServicesAmt>7830195</ProgramServicesAmt>
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      <AllOtherExpensesGrp>
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        <ProgramServicesAmt>18243607</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
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        <EOYAmt>2784495</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>72544</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>60042190</EOYAmt>
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        <EOYAmt>7336166</EOYAmt>
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        <EOYAmt>2184322</EOYAmt>
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        <EOYAmt>2904714</EOYAmt>
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        <EOYAmt>1707677</EOYAmt>
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        <EOYAmt>388439072</EOYAmt>
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        <EOYAmt>9706</EOYAmt>
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        <EOYAmt>9818606</EOYAmt>
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        <EOYAmt>45625704</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>165591179</EOYAmt>
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        <EOYAmt>222847506</EOYAmt>
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        <EOYAmt>387</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>388439072</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
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      <OtherChangesInNetAssetsAmt>-17664370</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
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    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001" />
    <IRS990ScheduleD documentId="RetDoc1039900001">
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      <TotalAcreageCnt>1.52</TotalAcreageCnt>
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      <HistoricStrctrEasementsAftrCnt>1</HistoricStrctrEasementsAftrCnt>
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      <WrittenPolicyMonitoringInd>1</WrittenPolicyMonitoringInd>
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        <Amt>13258356</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Athletic sponsorship</Desc>
        <Amt>473967</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Due to affiliate</Desc>
        <Amt>111101</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated amounts due to third-party payors</Desc>
        <Amt>4454534</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Physician income guarantee commitments</Desc>
        <Amt>174028</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Professional self-insurance liability</Desc>
        <Amt>11325121</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Synthetic lease obligations</Desc>
        <Amt>15828597</Amt>
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      <TotalLiabilityAmt>45625704</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Kettering Health Network has a policy on conservation easements. The expense to monitor the conservation easement is recorded as incurred to the hospital. There is no income from the easement, and no asset has been recorded.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Network completed an analysis of its certain and uncertain tax positions in accordance with applicable accounting guidance and determined that no amounts were required to be recognized in the consolidated financial statements at December 31, 2017 or 2016.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc1041500001">
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      <WrittenPolicyInd>1</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>1</FPGReferenceFreeCareInd>
      <Percent100Ind>X</Percent100Ind>
      <FPGReferenceDiscountedCareInd>1</FPGReferenceDiscountedCareInd>
      <Percent300Ind>X</Percent300Ind>
      <FreeCareMedicallyIndigentInd>1</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>1</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>1</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>0</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>1</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>1</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>6593471</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>2972406</DirectOffsettingRevenueAmt>
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        <TotalExpensePct>0.00890</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
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        <DirectOffsettingRevenueAmt>55286075</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>33884574</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.08360</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>95764120</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>58258481</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>37505639</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.09250</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
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        <DirectOffsettingRevenueAmt>1203899</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>3226395</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00800</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <TotalCommunityBenefitExpnsAmt>11647173</TotalCommunityBenefitExpnsAmt>
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        <NetCommunityBenefitExpnsAmt>6531823</NetCommunityBenefitExpnsAmt>
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      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
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      <CashAndInKindContributionsGrp>
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        <NetCommunityBenefitExpnsAmt>125461</NetCommunityBenefitExpnsAmt>
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      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>19477946</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>7559041</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>11918905</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02940</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>115242066</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>65817522</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>49424544</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.12190</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>3720599</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>89294</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>76742721</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>78080093</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-1337372</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>1 Grandview Associates</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>Medical Office Building</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.92000</OrgProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.08000</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>2 Southview Orthopedic Center Management Company LLC</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>Medical Service Venture</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.51000</OrgProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.49000</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <HospitalFacilitiesCnt>2</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>Grandview Medical Center</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>405 W Grand Avenue</AddressLine1Txt>
          <CityNm>Dayton</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45405</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>ketteringhealth.org</WebsiteAddressTxt>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>2</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>Southview Medical Center</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1997 Miamisburg Centerville Road</AddressLine1Txt>
          <CityNm>Centerville</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45459</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>ketteringhealth.org</WebsiteAddressTxt>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>Grandview Medical Center Group A</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>16</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>1</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>1</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>http://www.ketteringhealth.org/aboutus</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>17</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>http://www.ketteringhealth.org/aboutus</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>300.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>http://www.ketteringhealth.org/financial/pdfs/PatientFinancialAssistancePol</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>http://www.ketteringhealth.org/financial/pdfs/HCAP.pdf</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>http://www.ketteringhealth.org/financial/pdfs/PLS1.pdf</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <ProspectiveMedicareMedicaidInd>X</ProspectiveMedicareMedicaidInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Section A:</FormAndLineReferenceDesc>
        <ExplanationTxt>Each facility listed is required to be licensed, registered, or recognized as a healthcare facility under state law.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Section B</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility Reporting Group A</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility Reporting Group A consists of:</FormAndLineReferenceDesc>
        <ExplanationTxt>- Facility 1: Grandview Medical Center, - Facility 2: Southview Medical Center</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- Grandview Medical Center Part V, Section B, line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Twelve hospitals came together to conduct a collaborative Community Health Needs Assessment(CHNA), organized by The Health Collaborative in Cincinnati, Ohio and the Greater Dayton AreaHospital Association in Dayton, Ohio. Primary data collection involved interviews of public health officials, online and paper surveys, and community focus groups. The Grandview and Southview Medical Center committees received detailed information about the health issues identified in Greene, Montgomery, Preble and Warren counties. Hospital leaders prioritized and developed strategies to address these issues. This was performed during 2016.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- Grandview Medical Center Part V, Section B, line 6a:</FormAndLineReferenceDesc>
        <ExplanationTxt>Fort Hamilton HospitalGrandview Medical CenterGreene Memorial HospitalKettering Medical CenterSoin Medical CenterSouthview Medical CenterSycamore Medical CenterAtrium Medical CenterGood Samaritan HospitalMiami Valley HospitalUpper Valley Medical CenterWilson Health</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- Grandview Medical Center Part V, Section B, line 6b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Greater Dayton Area Hospital AssociationThe Health Collaborative</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- Grandview Medical Center Part V, Section B, line 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>Five health priorities were identified for the service area: heart disease, breast cancer, diabetes, chronic lower respiratory disease and cerebrovascular disease. Two of these, diabetes and breast cancer, will be addressed by Grandview Medical Center. Kettering Medical Center will address Heart Disease in its Implementation Strategy for this service area. Chronic Lower Respiratory Disease and Cerebrovascular Disease will be addressed by Public Health-Dayton &amp; Montgomery County (PHDMC) in their Community Health Improvement Plan (CHIP).</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Southview Medical Center Part V, Section B, line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Twelve hospitals came together to conduct a collaborative Community Health Needs Assessment(CHNA), organized by The Health Collaborative in Cincinnati, Ohio and the Greater Dayton AreaHospital Association in Dayton, Ohio. Primary data collection involved interviews of public health officials, online and paper surveys, and community focus groups. The Grandview and Southview Medical Center committees received detailed information about the health issues identified in Greene, Montgomery, Preble and Warren counties. Hospital leaders prioritized and developed strategies to address these issues. This was performed during 2016.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Southview Medical Center Part V, Section B, line 6a:</FormAndLineReferenceDesc>
        <ExplanationTxt>Fort Hamilton HospitalGrandview Medical CenterGreene Memorial HospitalKettering Medical CenterSoin Medical CenterSouthview Medical CenterSycamore Medical CenterAtrium Medical CenterGood Samaritan HospitalMiami Valley HospitalUpper Valley Medical CenterWilson Health</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Southview Medical Center Part V, Section B, line 6b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Greater Dayton Area Hospital AssociationThe Health Collaborative</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Southview Medical Center Part V, Section B, line 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>Five health priorities were identified for the service area: heart disease, breast cancer, diabetes, chronic lower respiratory disease, and cerebrovascular disease. Two of these, diabetes and breast cancer, will be addressed by Southview Medical Center. Kettering Medical Center will address Heart Disease in its Implementation Strategy for this service area. Chronic Lower Respiratory Disease and Cerebrovascular Disease will be addressed by Public Health-Dayton &amp; Montgomery County (PHDMC) in their Community Health Improvement Plan (CHIP).</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>11</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - Beavercreek Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2510 Commons Boulevard</AddressLine1Txt>
            <CityNm>Beavercreek</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45431</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - Cornerstone Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7740 Washington Village Drive</AddressLine1Txt>
            <CityNm>Centerville</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45459</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - Corwin M Nixon Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1470 N Broadway</AddressLine1Txt>
            <CityNm>Lebanon</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45036</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - Dayton Medical Imaging</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>113 W National Road</AddressLine1Txt>
            <CityNm>Vandalia</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45377</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>5 - Englewood Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1250 National Road</AddressLine1Txt>
            <CityNm>Englewood</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45322</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>6 - Huber Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>8701 Old Troy Pike</AddressLine1Txt>
            <CityNm>Huber Heights</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45424</ZIPCd>
          </USAddress>
          <FacilityTxt>Emergency, Outpatient Clinic, &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>7 - Preble County Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>450-B Washington-Jackson Road</AddressLine1Txt>
            <CityNm>Eaton</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45320</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>8 - Sugarcreek Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>6438 Wilmington Pike</AddressLine1Txt>
            <CityNm>Dayton</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45459</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>9 - Troy Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>700 South Stanfield Rd Suite B</AddressLine1Txt>
            <CityNm>Troy</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45373</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>10 - Victor J Cassano Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>165 Edwin C Moses Boulevard</AddressLine1Txt>
            <CityNm>Dayton</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45402</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>11 - Yankee Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7677 Yankee Street</AddressLine1Txt>
            <CityNm>Centerville</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45459</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinic &amp; Diagnostic Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 6a:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization provides an annual community benefit report that is made available to the public.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>Charity care is calculated using a cost to charge ratio following the methodology of Worksheet 2. Medical costs are calculated using a cost accounting system that addresses all patient segments. Community health improvement services are calculated on the basis of direct expenditures. Health professions education is calculated based on the Medicare cost report. Subsidized health services is calculated based on the non-Medicare, Medicaid and charity care proportion of departmental losses for the specific programs. Cash and in-kind contributions are calculated on the basis of direct expenditures.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7g:</FormAndLineReferenceDesc>
        <ExplanationTxt>Subsidized health services represent the non-needs based and non-Medicare program losses of services the hospital offers.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The overall cost to charge ratio was applied to charges associated with uncollectible accounts.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>An industry average was used to estimate this amount. It was not included as part of community benefit.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>A cost to charge ratio was used to determine the amount reported in Part III, Line 2. An industry average was used to compute the amount on Line 3. Discounts and payments on patient accounts reduce bad debt expense. No portion of bad debt expense is reported as community benefit. Text of footnote describing bad debt expense is as follows:"Based on historical experience, a significant portion of the Network's uninsured patients will be unable or unwilling to pay for the services provided. Thus, the Network records a significant provision for bad debts related to uninsured patients in the period the services are provided."</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>The costing methodology used to determine Medicare costs is the Medicare cost report. Medicare costs have not been included in community benefit in Part I.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Financial counselors work out a payment program for any amount due after the Charity Sliding Scale Discounts are applied. Collection procedures consistent with self-pay accounts are applied to these balances.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Grandview, as part of Kettering Health Network, has dedicated an entire department to community health and wellness. The Community Outreach Department is comprised of coordinators who develop programs, screenings and other health related events. The department also has fitness specialists, nurses, dietitians, massage and behavioral therapists, a communication specialist, health coaches, a physician medical director, a full service call center, and many other resource personnel.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>Grandview informs and educates patients or persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under Grandview's charity care policy as follows:-Grandview has a financial assistance brochure that is included in all of the patient information kits given at the time of intake or registration into any facility or department.-There is information posted in all of the admitting and registration areas about charity care and financial assistance.-During the registration process there is specific scripting to ask patients if they would like to disclose family size and income to screen them for federal/state/local and hospital based charity/assistance programs. This data is available for future visits as well.-Grandview has the reporting capability to review and screen any patient who may have been admitted during registration "off hours" for eligibility and assistance.-Grandview contracts with an outside agency for patient assistance in the application process.-The back of the patient statement shows the current and prior year Federal Poverty Guidelines and has the Financial Assistance Form to complete and mail in for consideration for Grandview's HCAP or Charity Sliding Scale program.-Grandview's patient account representatives in customer service screen patients that are unable to pay their bill for the various financial assistance programs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>KHN serves a population of approximately 1,682,000 in its primary and secondary service area. The nine-county service area includes Butler, Clark, Clinton, Darke, Greene, Miami, Montgomery, Preble and Warren counties. Out of this services area, approximately 12.6% of area households have income below $15,000, 10.7% have income between $15,000 and $24,999, and 24.9% have income between $25,000 and $49,000. Portions of each county except Preble county have been identified as medically underserved by the Health Resources and Services Administration. This nine-county area is served by 15 hospitals, 8 of which are part of Kettering Health Network.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Grandview furthers its exempt purpose by promoting the health of the community by:-Retaining a Board of Directors with a majority (excluding employees and contractors) living in the primary service area;-Extending medical staff privileges to all qualified physicians in its community for a majority of its departments;-Utilizing surplus funds to help support ongoing improvements in patient care through equipment upgrades, acquisition of the most advanced medical technology, upgrades of existing hospital structures, and construction of new facilities in order to provide accessible, efficient, quality care. -As a nationally-recognized osteopathic teaching hospital, Grandview partners with the Ohio University College of Osteopathic Medicine to enhance state-of-the-art medical education tools and programs. Medical research is supported through the Innovation Center, cultivating new technologies and fostering best practices among partners from industry, academia, and health care.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>Grandview and its affiliates promote the health of the communities served by the system as described below:-Grandview, a part of the Kettering Health Network, is dedicated to the creation and maintenance of community wellness programs, support groups and health education programs. Grandview provides numerous screenings, family-focused classes, health fairs, conferences, donations, and education programs to ensure the long-term wellbeing of people living in the community.-Grandview is affiliated with the Ohio University College of Osteopathic Medicine. The teaching programs have been an integral part of Grandview's emergence as one of the nation's leading Osteopathic hospitals for clinical quality.-The Grandview Foundation is the philanthropic arm of Grandview Medical Center and supports the education of future osteopathic physicians.-Kettering Affiliated Health Services, Inc includes Sycamore Glen Health Center and Sycamore Glen Retirement Community. These healthcare areas provide services to the surrounding communities which complement those services provided by Grandview as part of the Kettering Health Network.-Medical research is supported through the Innovation Center, which cultivates new technologies and fosters best practices among partners from industry, academia, and health care.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7, Reports Filed With States</FormAndLineReferenceDesc>
        <ExplanationTxt>OH</ExplanationTxt>
      </SupplementalInformationDetail>
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        <NontaxableBenefitsRltdOrgsAmt>8877</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>385955</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation is established by a related organization. The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Lines 4a-b</FormAndLineReferenceDesc>
        <ExplanationTxt>Terri Day received a severance payment of $377,078. The Network has a supplemental executive retirement plan available only to a certain class of management.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Col Biii</FormAndLineReferenceDesc>
        <ExplanationTxt>Column Biii includes compensation reported on the W-2 that may or may not have gone through the current year Statement of Operations and Changes in Net Assets.</ExplanationTxt>
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    </IRS990ScheduleJ>
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      <TaxExemptBondsIssuesGrp>
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        <BondReferenceCd>C</BondReferenceCd>
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        <BondReferenceCd>B</BondReferenceCd>
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      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
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        <HedgeIdentifiedInBksAndRecInd>1</HedgeIdentifiedInBksAndRecInd>
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          <BusinessNameLine1Txt>Merrill Lynch</BusinessNameLine1Txt>
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        <HedgeTerminatedInd>0</HedgeTerminatedInd>
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        <BondReferenceCd>B</BondReferenceCd>
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      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
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        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
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        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
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        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
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        <BondReferenceCd>B</BondReferenceCd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Fred Manchur, CEO - KHN, is the father of Richard Manchur, President SVMC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A tax specialist is engaged to review the 990. The 990 is reviewed and accepted by the audit committee which reports this to the governing body (board).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Network regularly and consistently monitors and enforces compliance with the conflict of interest policy by making it part of the employees' annual reviews. Employees must certify that they have read the conflict of interest policy and have disclosed any potential conflicts and agree to immediately notify Corporate Integrity if one should arise. Board members are required to annually review the Network's policy, sign a conflict of interest statement, and notify the Network if a conflict should arise.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's governing documents, conflict of interest policy, and financial statements are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Net transfers to affiliate -20,378,915. Change in plan assets and benefit obligation of pension plan 2,714,545.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>Neither the oversight process nor the selection process changed during the tax year.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Alliance Physicians Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
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        <PrimaryActivitiesTxt>Physician Services</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Beavercreek Medical Center</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
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          <BusinessNameLine1Txt>The Fort Hamilton Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <AddressLine1Txt>405 W Grand Avenue</AddressLine1Txt>
          <CityNm>Dayton</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45405</ZIPCd>
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        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Greene Foundation</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
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          <BusinessNameLine1Txt>Greene Memorial Hospital</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Greene Memorial Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
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        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>509(a)(1)</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Greene Oaks</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>310999724</EIN>
        <PrimaryActivitiesTxt>Senior Healthcare Facilities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(2)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Kettering Affiliated Health Services Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>311051688</EIN>
        <PrimaryActivitiesTxt>Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Affiliated Health Services Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>311127485</EIN>
        <PrimaryActivitiesTxt>Health Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
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        </USAddress>
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        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Kettering Medical Center Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>237419897</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(a)(3)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Grandview Associates</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>311427280</EIN>
        <PrimaryActivitiesTxt>Building Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Dayton Osteopathic Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>-32772</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>1274401</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>1</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.92000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Southview Orthopedic Center Management Company LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1997 Miamisburg-Centerville Rd</AddressLine1Txt>
          <CityNm>Dayton</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45459</ZIPCd>
        </USAddress>
        <EIN>262040203</EIN>
        <PrimaryActivitiesTxt>Medical Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Dayton Osteopathic Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>7378900</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>2393628</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>1</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.51000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Kettcor</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Prestige Place Suite 910</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <EIN>311078381</EIN>
        <PrimaryActivitiesTxt>Health Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Grandview Foundation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>2732176</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Alliance Physicians Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Alliance Physicians Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Grandview Foundation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Adventist Healthcare</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Kettering Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>20378915</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Kettering Medical Center is a conduit through which revenue is received and expenses are paid.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>