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        <PersonNm>John Epperly</PersonNm>
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      <Form990PartVIISectionAGrp>
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          <USAddress>
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      <ContractorCompensationGrp>
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      <ContractorCompensationGrp>
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          <USAddress>
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      <ContractorCompensationGrp>
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          <BusinessName>
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          <USAddress>
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        <ExplanationTxt>This amount is calculated based on information provided by the West Virginia Hospital Association and the American Hospital Association. The American Hospital Association estimates that 39 of the 2024 dues were allocated to lobbying expense. The West Virginia Hospital Association estimates that during 2024, 12.6 of the dues paid should be allocated to lobbying expense. Herbert J. Thomas Memorial Hospital Association does not participate in or intervene in including publishing or distributing of statements any political campaign on behalf of or in opposition to any candidate for public office.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Group Herbert J. Thomas Memorial Hospital Line Part V, Section B, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Effective January 1, 2023, Thomas Memorial Hospital joined the West Virginia United Health System. At that time West Virginia United Health System, Inc. became the sole member of Thomas Health System, Inc., the sole member of the filing Organization.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Herbert J. Thomas Memorial Hospital Line Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The 2024 CHNA reporting process overlapped with an administrative transition period for Thomas Hospital as it was incorporated into a new health system. The 2024 CHNA process began with a review of the 2020 Thomas Hospitals CHNA and 2022 KCCHI reporting. It also included a review of publicly available secondary data related to Kanawha and Putnam counties including US Census data, County Health Rankings Data, and select MATCH data from Kanawha and Putnam counties. Using this information as a springboard, the leadership team discussed critical health needs, changes in the community over the previous few years and with the recent administrative changes to area hospitals, and lessons learned from the last CHNA cycles health topic prioritization and development of implementation activities. A brief supplemental survey for select key partners was developed using an iterative process. The survey was aimed to remind respondents of the 2022 KCCHI survey outcomes and prioritized health topics, ask them to reflect on these in a fall 2024 context, and to provide their overall perceptions of current health issues in Kanawha and Putnam counties. This survey was developed, hosted, and analyzed using Quatlrics, and data was collected from a small group of participants using a single anonymous link. This link was shared by hospital leadership directly to their selected partners. It was not intended to be representative of any one population or perspective, but rather a mechanism for incorporating the communities robust 2022 KCCHI data into this transitional 2024 CHNA reporting.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Herbert J. Thomas Memorial Hospital Line Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The following organizations were represented on Thomas Hospitals CHNA leadership team and provided input throughout the process of developing the CHNA Thomas Hospital administration, compliance, physicians, board members, foundation members, pastoral care, patient family representative, behavioral health, community-based program individuals, marketing, and the Kanawha Coalition for Community Health Improvement.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Herbert J. Thomas Memorial Hospital Line Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>The existing secondary data, most recent KCCHI data, new supplemental primary data from partners, and lessons learned from the last CHNA cycle all factored into Thomas Hospitals prioritization decisions. The health priorities for implementation planning are mental health and substance use disorder, wellness promotion, and wellness resources. The following are ideas for implementation strategy development as well as organizations identified at addressing top health concerns Food is Medicine program, FARMacy WV, existing programming addressing obesity and weight loss, food distribution programs, and various clinical resources and food resources.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>1</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Thomas Orthopedic Hospital</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>333 Laidley Street</AddressLine1Txt>
            <CityNm>Charleston</CityNm>
            <StateAbbreviationCd>WV</StateAbbreviationCd>
            <ZIPCd>25301</ZIPCd>
          </USAddress>
          <FacilityTxt>Orthopedic Hospital</FacilityTxt>
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      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3c</FormAndLineReferenceDesc>
        <ExplanationTxt>Thomas Memorial Hospital TMH uses 200 Federal Poverty Guideline to determine free care eligibility. TMH offers a Prompt - Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 50 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible for either prompt pay discount the patient/guarantor must meet certain requirements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Thomas Memorial Hospital community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The most recent amounts can be found at the following web address http//wvumedicine.org/about/leadership-and-more/community-benefit/.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>The cost of charity care and unreimbursed Medicaid was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions. The Bad Debt expense included on Form 990, Part IX, Line 25A, but subtracted for purposes of calculating the percentage in this column is 16,161,328.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>No community building activites were reported during the reporting period.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debt Expense at cost was calculated by multiplying bad debt expense - patients of 16,161,328 by our cost to charge ratio of 33.03 for a total of 5,338,087.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Estimated bad debt attributable to patients eligible for charity care was calculated by applying the assumption that at least 15 of the balance in bad debt could be charity care if patients would complete the application. The total of that calculation was 800,713</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Patient accounts receivables are primarily paid by federal and state governmental authorities under the Medicare and Medicaid programs, managed health plans, commercial insurance companies, workers compensation programs, employers and patients. Patient accounts receivable are reported at net realizable value. For accounts receivable associated with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions. The System does not believe there are any significant concentrations of revenues from any particular payor that would subject the System to any significant credit risks in the collection of patient accounts receivable. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters. Changes in general economic conditions, patient accounting service center operations, payor mix, payor claim processing could affect collections of accounts receivable, cash flows and results of operations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The System performs periodic assessments to determine if an allowance for expected credit losses is necessary. The System considers its incurred loss experience and adjusts for known and expected events and other circumstances. In estimating its expected credit losses, the System may consider changes in the length of time its receivables have been outstanding, changes in credit ratings for payors, requests from payors to alter payment terms due to financial difficulty, and notices of payor bankruptcies or payors entering receivership. Because the Systems accounts receivable is typically paid for by highly solvent, creditworthy payors, such as Medicare, Medicaid, other governmental programs, and highly regulated commercial insurers on behalf of the patient, the Systems credit losses are immaterial to the consolidated financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The mix of accounts receivable at December 31, 2024 and 2023, from patients and third-party payors is as follows For the year-end December 31, 2024 Medicare - 22, Medicaid - 11, Blue Cross - 24, Commercial, managed care and other - 40, Patients - 3, totaling 100. For the year-end December 31, 2023 Medicare - 25, Medicaid - 13, Blue Cross - 21, Commercial, managed care and other - 39, Patients - 2, totaling 100.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount reported in Part III Line 6 378,191,946 was calculated by applying the overall cost to charge ratio from the most recently filed cost report and applying that rate to the total charges for the shirt year reporting period.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Thomas Memorial Hospitals 24,040,913 shortfall of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>Once Thomas Health System determines that a patient is eligible for Financial Assistance, that patient shall not receive any future bills based on undiscounted gross charges. The amount charged for emergency or other medically necessary care to a Financial Assistance eligible individual will not be more than the amounts generally billed to received by either THS Physician Partners, Thomas Memorial or Saint Francis Hospital. Medicare fee-for-service and commercially insured patients. The amounts generally billed are calculated using the look-back method based on actual past claims paid to THS Physician Partners, Thomas Memorial Hospital or Saint Francis Hospital, as applicable, in the prior fiscal year by Medicare fee-for-service together with all private health insurers. The amounts generally billed will be recalculated annually. If it is not known that a patient is eligible for Financial Assistance, usual charges will be billed and if it is later determined that the individual is eligible, any excess payments will be refunded.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The most recent community health needs assessment can be found here - https//wvumedicine.org/wp-content/uploads/2025/04/Thomas-Hospitals-Community-Health-Needs-Assessment-2024-20241119.pdf.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital informs and educates patients about their eligibility for assistance by 1 providing a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process 2 including the policy, or a summary thereof, along with financial assistance contact information, in patient bills and 3 discussing with the patient the availability of various government benefits, such as Medicaid or state programs, and assisting the patient with qualification for such programs, where applicable. For those patients who come into our office after they receive a bill, we explain this same process to them. We also employ an outside agency, Advanced Patient Advocacy APA, to speak with patients regarding Medicaid and other state and federal funding options. APA may speak with the patient during a stay or visit or after discharge. Hospital also has a DHHR employee on campus to help with getting the employees enrolled into Medicaid.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The organizations geographic service area includes approximately 476,000 persons in a 12 county area of south-central West Virginia. Heart disease, cancer and pulmonary disease are the leading causes of death in the service area. Patients in the service area are typical of West Virginia as a whole. Except for the area within the Charleston, WV city limits, all of the counties in the organizations geographic service area are federally-designated Medically Underserved and Health Manpower Shortage Areas. Thomas Memorial Hospital is located within the city limits of South Charleston, West Virginia and is in Kanawha County. South Charleston is an urban area. Per the United States Census Bureaus quick facts, the estimated Population of Kanawha County is 174,805. The median household income is 55,226 and 17.7 are below poverty level. 7.5 of Kanawha County adults under 65 are uninsured. There are 6 hospitals which serve the community.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital extends medical staff privileges to all qualified physicians in the community who meet specific credentialing criteria. The hospitals 24 hour emergency room is available to all persons, regardless of ability to pay. The hospital prepares its budget to ensure adequate funding for capital improvements that are made on an on-going basis.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>As of January 1, 2023, Thomas Memorial Hospital and related organizations under Thomas Health System, became a member of the West Virginia United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery system. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional health care delivery system in its service areas, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include West Virginia University Hospitals, Inc. in Morgantown, WV, United Hospital Center in Bridgeport, WV, Camden-Clark Memorial Hospital in Parkersburg, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Potomac Valley Hospital in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, West Virginia Healthcare Cooperative, doing business as, Summersville Regional Medical Center in Summersville, WV, Braxton County Memorial Hospital in Gassaway, WV, Community Health Association, doing business as, Jackson General Hospital in Ripley, WV, Reynolds Memorial Hospital in Glen Dale, WV, Barnesville Hospital Association in Barnesville, OH, Uniontown Hospital in Uniontown, PA, Wheeling Hospital, Inc. in Wheeling, WV, Harrison Community Hospital, Inc. in Cadiz, OH, GRMC, Inc. in Oakland, MD, Princeton Community Hospital Association, Inc. in Princeton, WV, and Grant Memorial Hospital, Inc. in Petersburg, WV.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>In addition to the above mentioned hospitals, the System includes physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, Inc. a behavioral health center located in Clarksburg, WV. The System also includes, WVUH-East, Inc. and Camden-Clark Health Services, Inc. which operate as management companies for their respective hospitals. University Healthcare Foundation, Inc. in Martinsburg, WV, United Health Foundation, Inc. in Bridgeport, WV, Camden-Clark Foundation, Inc. in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, Inc. in Glen Dale, WV, and Barnesville Hospital Foundation in Barnesville, OH which perform various fundraising activities for their respective hospitals. In 2020, the System formed WVUHS Home Care, LLC to provide Home Health and Hospice services to our service areas, supporting System hospitals by providing continuous care to our patients. Wheeling Hospital Ambulatory Surgical Center, LLC a surgical center located in Bridgeport, OH was acquired in 2021.</ExplanationTxt>
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          <AddressLine1Txt>1116 Smith Street</AddressLine1Txt>
          <CityNm>Charleston</CityNm>
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        <ExplanationTxt>Thomas Memorial Hospital does not track the use of funds once they are donated, however contributions made are in alignment with the overall mission of the hospital.</ExplanationTxt>
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        <PersonNm>Daniel J Lauffer</PersonNm>
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        <PersonNm>J Gregory Rosencrance</PersonNm>
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        <PersonNm>Kevin Sloan</PersonNm>
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        <TotalCompensationRltdOrgsAmt>900756</TotalCompensationRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Michael Sitler</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <BaseCompensationFilingOrgAmt>197672</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>574</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>44684</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>17160</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>260090</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Aaron Alexander</PersonNm>
        <TitleTxt>VP General Counsel</TitleTxt>
        <BaseCompensationFilingOrgAmt>32012</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>259005</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>4661</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>37715</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>3225</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>26097</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>2353</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>19040</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3366</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>27235</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>45617</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>369092</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Luke Martin MD</PersonNm>
        <TitleTxt>Director/Medical Staff President</TitleTxt>
        <BaseCompensationFilingOrgAmt>590170</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>73925</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>809</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15525</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>6665</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>687094</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>CEO compensation is determined by the WV United Health System compensation committee. The System engages an independent group to perform an executive compensation review and compensation survey annually. This information is provided to the committee, which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package offered does not exceed fair market value.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4a</FormAndLineReferenceDesc>
        <ExplanationTxt>The following individuals received severance pay in 2024 Timothy Skeldon received 286,316 Elizabeth Davis received 268,116 and Lewis Perkins received 71,905.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>During 2024, the following individuals were able to defer compensation under a nonqualified plan. The amounts reported here are included in Part II Column C of the Schedule J. Albert Wright deferred contributions of 375,320 from related party, Rachel Jones deferred contributions of 13,500, Leslie Lawson deferred contributions of 25,281, Gregory Rosencrance deferred contributions of 66,162, Brian Lilly deferred contributions of 23,234, Matthew Upton deferred contributions of 20,904, Mary Caldwell deferred contributions of 15,654, Lewis Perkins deferred contributions of 17,173, Kristin Anderson deferred contributions of 18,480, Tom Takubo deferred contributions of 90,383 from related party, Michael Sitler deferred contributions of 39,137, and Aaron Alexander deferred contributions of 7,851 from related party Column C can and does include amounts that were contributed as a part of the standard retirement package if it was available to the employee during the year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Per the WVUHS Incentive Plan incentives are contingent on meeting a net earning target.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The following individuals received CAA contributions in 2024. Gregory Rosencrance in the amount of 24,375, Timothy Skeldon in the amount of 13,545, Elizabeth Davis in the amount of 2,716, and Aaron Alexander in the amount of 26,170 from related party. These amounts were appropriately reported as compensation on Form W-2 for 2024.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Effective May 1, 2024, West Virginia United Health System, Inc. a West Virginia non-profit became the sole member of Herbert J. Thomas Hosptial Association. At that time Charleston Hospital d/b/a St. Francis Hospital, ceased to exist as a separate legal entity and became a department of Herbert J. Thomas Hospital.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Draft copies of the Form 990 are sent to the board members for review. Questions and discussion are then asked or held during the board meeting. If no errors are found, the board approves the filing of Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Monitoring and enforcing compliance with conflict of interest policy on an annual basis. Officers, directors, trustees, and key employees are required to disclose potential conflicts of interest by completing the hospitals conflict of interest form. If potential conflicts exist, the person would then contact their manager or the compliance officer for the conflict to be investigated and action taken if necessary. The corporate compliance committee oversees the conflict of interest policy and monitors and enforces this policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>In 2023, West Virginia United Health System WVUHS, EIN 55-0754713, transitioned to a centralized accounts payable process in which WVUHS made the majority of vendor payments and then issued the required 1099s. WVUHS is reimbursed by the entities for their portion of payments made, vendor payments that meet the Top 5 Independent Contractor reporting requirements are reported in Part VII, Section B of the reporting entity.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of all officers at the Vice President level and below is determined based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This data is then interpreted and provided to an independent compensation committee. The independent compensation committee then uses this data to determine a fair and reasonable compensation package. All relevant data as well as minutes from each meeting are retained.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request. These documents are maintained in the administrative offices of the hospital and are provided via copy upon request. The documents also can be reviewed on site at the hospital upon advance notice.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount reported on line 11g consists of the following Consulting and Professional Fees of 10,305,592 of which 8,722,889 is considered program service and 1,582,703 is considered management and general Contract Labor/Purchased Services of 37,595,286 of which 36,763,954 is considered program service and 831,332 is considered management and general Lab Fees of which 297 of which all is considered program service and Collection Fees of 252,363 of which 75,616 is considered program service and 176,747 is considered management and general.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Changes in Net Assets of 239,357,043 are a result of related organization capital transfers when Thomas Health System and Charleston Hopsital were merged into Thomas Memorial Hospital.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 23</FormAndLineReferenceDesc>
        <ExplanationTxt>TMH received a refund of malpractice insurance premiums during 2024 which is causing insurance expense to show as a negative expense.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <BusinessNameLine1Txt>Braxton County Memorial Hospital Inc</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Wetzel County Hospital Inc</BusinessNameLine1Txt>
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          <StateAbbreviationCd>PA</StateAbbreviationCd>
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          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
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        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Harrison Community Hospital Inc</BusinessNameLine1Txt>
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      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TMH Services</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>k</TransactionTypeTxt>
        <InvolvedAmt>766983</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Accounting Records</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>