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    <BuildTS>2021-01-29 14:40:06Z</BuildTS>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jack Endres</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Warren Robicheaux</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Adron Neill</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Beverly Waddleton MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Curt Smith</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Allen Bell</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Harry Tilley</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Andrew Bentley MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Ann Lake</PersonNm>
        <TitleTxt>Director</TitleTxt>
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        <PersonNm>Rocky Gill</PersonNm>
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        <PersonNm>Barry Hughes</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BG Hartley</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Bill Clawater</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Evan Smith MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jeff Taylor</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Brian Ballard</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Brian Holcomb</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Bryan Hyland MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Bryan Price</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>John Cain</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Charles Halstead</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Sebetha Jenkins-Booker PHD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Curtis E Grey MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Dale Lagrone</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>David Craig MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Donald Lewis</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>David Johnson MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>David Jones MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>David Latham MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Donna Bennett</PersonNm>
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        <PersonNm>Laura Vanecek</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Donald E Arego MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Doug Johnston DO</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Eldor Brish MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Fred A Heirich</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Gary Gross MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Elam Swann</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>George Robinson</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>George T Hall</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Holley Howard</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Harold Beaird</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JB Smith</PersonNm>
        <TitleTxt>Director</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Troy Robinson</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>J Michael Orms MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jack Dickerson</PersonNm>
        <TitleTxt>Director</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jerry Webster</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jessica Parish</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Joe Angle</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>John Payne</PersonNm>
        <TitleTxt>Director</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Joyce Starling MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>John Magouyrk</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>John T Wilson</PersonNm>
        <TitleTxt>Director</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jon Johnston</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Karen Wies MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jean Burroughs</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Larry Durrett</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Larry King</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Lawrence Quan MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Leesa N Hedge</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Lisa Graves MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Marinel Munda MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Michael Austin MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Michael Banks DDS</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Michelle Brookshire</PersonNm>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kathy Babin</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Michael Young</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Ned Muse</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Virginia Lewis</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Patricia Smith</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Paul Latta DDS</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Nichols</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Robyn Rogers</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Rodney Watkins</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Randy Karnes</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Ron Franks</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Rosemary Burns</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Sam Dawson</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Salah Almohammed MD</PersonNm>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Samual Houston MD</PersonNm>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stayton Bonner</PersonNm>
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        <PersonNm>Steven C Roosth</PersonNm>
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        <PersonNm>Brock Lutz MD</PersonNm>
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        <PersonNm>Sue Murray</PersonNm>
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        <PersonNm>Todd Parrish MD</PersonNm>
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        <PersonNm>WR Christensen MD</PersonNm>
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        <PersonNm>Wayne Mask MD</PersonNm>
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        <PersonNm>Tony Farmer</PersonNm>
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        <PersonNm>Kim Cooley</PersonNm>
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        <PersonNm>Robert Evans</PersonNm>
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        <PersonNm>James Blanton</PersonNm>
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        <PersonNm>Becki Mangum</PersonNm>
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        <PersonNm>David Travis</PersonNm>
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        <PersonNm>Patrick Swindle</PersonNm>
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        <PersonNm>Janet Andersen</PersonNm>
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        <PersonNm>Phil Caron</PersonNm>
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        <PersonNm>Freddie Sanchez</PersonNm>
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        <PersonNm>David Langston</PersonNm>
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        <PersonNm>Carroll Roge</PersonNm>
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        <PersonNm>Dennis S Devinney</PersonNm>
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        <PersonNm>Alireza Behboudi</PersonNm>
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        <PersonNm>Michael J Klouda</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Roger Sessions MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>William Roberson D</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Mike Thomas</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Terry Cutler</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Sam Brown</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Andrew Roberts MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>David Mandel MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Gary Babbitt MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Garald Akpassa MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Gordon Uretsky MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Nghia Truong MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Sam Raborn MD</PersonNm>
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        <ContributionsAmt>452285</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>635449</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>224950</OtherExpendituresAmt>
        <EndYearBalanceAmt>7265021</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>5394150</BeginningYearBalanceAmt>
        <ContributionsAmt>1070831</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>555764</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>618508</OtherExpendituresAmt>
        <EndYearBalanceAmt>6402237</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>6070504</BeginningYearBalanceAmt>
        <ContributionsAmt>394384</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>272531</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>1343269</OtherExpendituresAmt>
        <EndYearBalanceAmt>5394150</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.27000</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.28000</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.45000</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>false</RelatedOrgListSchRInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>361505</OtherCostOrOtherBasisAmt>
        <BookValueAmt>361505</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>180680892</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>88376379</DepreciationAmt>
        <BookValueAmt>92304513</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>36081932</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>13759519</DepreciationAmt>
        <BookValueAmt>22322413</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>339761566</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>276027396</DepreciationAmt>
        <BookValueAmt>63734170</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>49295326</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>38682939</DepreciationAmt>
        <BookValueAmt>10612387</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>189334988</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Accrued Interest Receivable</Desc>
        <BookValueAmt>317</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Bonds Receivables &amp; Unamortized Bond Exp</Desc>
        <BookValueAmt>3302554</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Deposits on Equip &amp; Various Items</Desc>
        <BookValueAmt>15500</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Due From Affiliates</Desc>
        <BookValueAmt>568397562</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Due From Outside Entities</Desc>
        <BookValueAmt>11108556</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Estimated 3rd Party Settlement</Desc>
        <BookValueAmt>1011225</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Goodwill-Athens Cancer Institute net</Desc>
        <BookValueAmt>1000000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Restricted Funds</Desc>
        <BookValueAmt>9110168</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Rounding</Desc>
        <BookValueAmt>1</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>593945883</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Capital Lease Obligations</Desc>
        <Amt>14611722</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred Direct &amp; Admin Expenses</Desc>
        <Amt>44281320</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to Affiliates</Desc>
        <Amt>184745487</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated 3rd Party Settlement</Desc>
        <Amt>741850</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Investment In Cyberknife</Desc>
        <Amt>-83659</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Noncurrent Pension Liability</Desc>
        <Amt>44272422</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Other Noncurrent Liabilities</Desc>
        <Amt>582762</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Rounding</Desc>
        <Amt>-2</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>289151902</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH" softwareId="15000324" softwareVersionNum="2015v3.0">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent200DInd>X</Percent200DInd>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>true</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>false</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>30861345</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>30693291</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>168054</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00020</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>66965895</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>66838672</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>127223</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00020</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
        <TotalCommunityBenefitExpnsAmt>8452306</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>6048775</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>2403531</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00290</TotalExpensePct>
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      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>106279546</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>103580738</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>2698808</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00330</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>403907</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>62538</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>341369</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00040</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <TotalCommunityBenefitExpnsAmt>783138</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>147638</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>635500</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00080</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>73326949</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>54492034</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>18834915</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02250</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <ResearchGrp>
        <TotalCommunityBenefitExpnsAmt>191328</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>82464</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>108864</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </ResearchGrp>
      <CashAndInKindContributionsGrp>
        <TotalCommunityBenefitExpnsAmt>23148776</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>23148776</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02760</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>97854098</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>54784674</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>43069424</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.05140</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>204133644</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>158365412</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>45768232</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.05470</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>81159</BadDebtExpenseAmt>
      <ReimbursedByMedicareAmt>195280372</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>259055427</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-63775055</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>false</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>10</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Athens</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>2000 South Palestine</AddressLine1Txt>
          <CityNm>Athens</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75751</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>2</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Cartha</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>409 West Cottage Road</AddressLine1Txt>
          <CityNm>Carthage</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75633</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>5</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Fairfi</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>125 Newman Street</AddressLine1Txt>
          <CityNm>Fairfield</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75840</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>6</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Hender</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>300 Wilson Street</AddressLine1Txt>
          <CityNm>Henderson</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75652</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>7</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Jackso</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>501 S Ragsdale Street</AddressLine1Txt>
          <CityNm>Jacksonville</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75768</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>9</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Pittsb</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>414 Quitman Street</AddressLine1Txt>
          <CityNm>Pittsburg</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75686</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>10</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Quitma</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>117 N Winnsboro Street</AddressLine1Txt>
          <CityNm>Quitman</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75783</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>11</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Trinit</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>317 Prospect Drive</AddressLine1Txt>
          <CityNm>Trinity</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75862</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>12</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Tyler</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1000 South Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>13</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>East Texas Medical Cntr-Specia</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1000 South Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>A</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>10</FacilityNum>
        <FirstLicensedCYOrPYInd>false</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <InformationGapsInd>X</InformationGapsInd>
        <CHNAConductedYr>15</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>true</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>false</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <RptAvailableThruOtherMethodInd>X</RptAvailableThruOtherMethodInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>15</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>false</StrategyPostedWebsiteInd>
        <StrategyAttachedInd>false</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>200.0000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>200.0000</FPGFamilyIncmLmtDscntCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <FAPActionsOnNonpaymentInd>false</FAPActionsOnNonpaymentInd>
        <CollectionActivitiesInd>true</CollectionActivitiesInd>
        <ReportingToCreditAgencyInd>X</ReportingToCreditAgencyInd>
        <FAPNotifiedUponAdmissionInd>X</FAPNotifiedUponAdmissionInd>
        <FAPNotifiedAllPatientsInd>X</FAPNotifiedAllPatientsInd>
        <DocumentedEligDeterminationInd>X</DocumentedEligDeterminationInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <OtherMethodUsedInd>X</OtherMethodUsedInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Line 5 - Account Input from Persons Who Represent the Community</FormAndLineReferenceDesc>
        <ExplanationTxt>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC (East Texas Medical Center). Individuals interview included representatives of: * A Matter of Balance - community fall provention program* Allstate Insurance* Andrew Center* Athens Independent School District* Beckville Independent School District* Bethesda Health Clinic* Camp County EMS* Camp County Judge* Camp County Sheriff* Carthage Independent School District* Carthage Primary School* CASA for Kids of East Texas* Century 21 Realty* City of Carthage Mayor* City of Pittsburg Mayor* City of Pittsburg Police Chief* Crisis Center of Anderson &amp; Cherokee Counties* Deputy Chief Appraiser* East Texas Crisis Center* East Texas Food Bank* Emergency Medical Resources* ET Council on Alcoholism &amp; Drug Abuse* ETMC Athens OB Clinic* ETMC Care Coordinator* ETMC EMS* ETMC First Physicians Clinic* ETMC Institutional Review Board (IRB)* ETMC Quitman Auxiliary* ETMC Trinity Admissions Department* Express Employment Professionals* Fairfield Emergency Medical Services director &amp; board member* Fairfield Hospital District* Family Resource Center* First Baptist Church - Pittsburg, TX* First United Methodist Church - Jacksonville, TX* Food Pantry* Former Prison Official* Gary Independent School District* Gateway Community Centers (MHMR)* Gibson Pharmacy* Hairdresser* Heavenly Threads Quilt Shop* Henderson Independent School District* Henderson Memorial Hospital Foundation* HOPE* Hospice of East Texas* In His Image Ministries* Jacksonville Fire Department* Jacksonville Police Department* Labor of Love* Local Pator - Carthage, TX* Luminant* Meals on Wheels* Mental Health Task Force* Northeast Texas Child Advocacy Center* Northeast Texas Public Health District* Panola College* Panola County* Panola County Court of Law* PATH* Pilgrim Bank* Pittsburg Dentist* Quitman &amp; Mineola Clinics* Refuge of Light* Resident - Dew, TX* Resident - Fairfield, TX* Retired Trinity Residents* Rusk County Clinic* Rusk County Judge* Rusk County Sheriff Office* Salvation Army* St. Matthews Episcopal Church* TAMU AgriLife Extension Service* Texas Dept. of State Health Services* The Clothes Closet* The Help Center* Trinity Tabernacle Assembly of God* Tyler Police Department* United Way of Smith County* Wesley House Assisted Living* Women's Health* Wood County Central Hospital District* Wood County Electric Cooperative* YMCAThe interview task force included the administrator from each ETMC Hospital, as well as members of the ETMC Regional Healthcare System's CHNA team.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>ETMC TylerETMC AthensETMC CarthageETMC FairfieldETMC Henderson ETMC JacksonvilleETMC PittsburgETMC QuitmanETMC TrinityETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationEast Texas Flight Ambulance dba Air OneETMC Healthcare AssociatesETMC Specialty HospitalETMC EMS</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Line 7d - Description of Making Needs Assessment Widely Available</FormAndLineReferenceDesc>
        <ExplanationTxt>Presented at community summary meeting.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Line 22d - Other Billing Determination of Individuals Without Insurance</FormAndLineReferenceDesc>
        <ExplanationTxt>A 60% discount is applied to standard charges.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>8</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>East Texas Medical Center - Rehab</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>701 Olympic Plaza Circle</AddressLine1Txt>
            <CityNm>Tyler</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75701</ZIPCd>
          </USAddress>
          <FacilityTxt>Rehabilitation Center, Physical and Occupational, Inpatient and Outpatient</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>East Texas Medical Center - Foundation</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1000 S Beckham Ave</AddressLine1Txt>
            <CityNm>Tyler</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75701</ZIPCd>
          </USAddress>
          <FacilityTxt>Support related hospitals within the system through raising, management and distribution of charitab</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>East Texas Medical Center - Healthcare Associates</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1000 S Beckham Ave</AddressLine1Txt>
            <CityNm>Tyler</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75701</ZIPCd>
          </USAddress>
          <FacilityTxt>Physicians</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>East Texas Medical Center - Home Services</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1000 S Beckham Ave</AddressLine1Txt>
            <CityNm>Tyler</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75701</ZIPCd>
          </USAddress>
          <FacilityTxt>Home Healthcare Services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>East Texas Medical Center - Self Insurance Trust</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1000 S Beckham Ave</AddressLine1Txt>
            <CityNm>Tyler</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75701</ZIPCd>
          </USAddress>
          <FacilityTxt>Insurance coverage for the East Texas Medical Center Regional Healthcare System.</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>East Texas Flight Ambulance dba Air One</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1000 S Beckham Ave</AddressLine1Txt>
            <CityNm>Tyler</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75701</ZIPCd>
          </USAddress>
          <FacilityTxt>Provide air ambulance service.</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>East Texas Medical Center Specialty Services</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>PO Box 6720</AddressLine1Txt>
            <CityNm>Tyler</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75711</ZIPCd>
          </USAddress>
          <FacilityTxt>Cardiovascular services</FacilityTxt>
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        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>ETMC EMS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1000 South Beckham Avenue</AddressLine1Txt>
            <CityNm>Tyler</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75701</ZIPCd>
          </USAddress>
          <FacilityTxt>Provide ground ambulance service.</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b - Provisions On Collection Practices For Qualified Patients</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization does not pursue collection of amounts determined to qualify as charity care and therefore are not considered in the collection policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI - Needs Assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>The community health needs assessment process adopted by ETMC was divided into three major components:- Internal and External Data Collection and Analysis- Community Assessment of Community Need- ETMC Provider InputThe community health needs assessment process is designed to measure positive and negative progress relative to selected health status indicators; target needs by population group, geographic market segment and health issue; consider community input and feedback; and identify opportunities for program and service development and enhancement.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI - Patient Education of Eligibility for Assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>Notifications of financial assistance and the Charity Care program are posted in the patient admission areas and emergency departments, and also printed in local newspapers. The Charity Care policy and application for financial assistance are also available on the internet at www.etmc.org. Additionally, notification of availability of financial assistance is noted on all patient billing statements, along with the phone number of whom to contact for financial assistance. In addition, direct contact is made to those individuals that the organization beleves may qualify for Charity Care, based on lack of insurance or other indications, to explain the availability of financial assistance and to request the individual complete and returned an application.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI - Community Information</FormAndLineReferenceDesc>
        <ExplanationTxt>The 20 county service area is composed of about 16 percent of the population over age 65, an increasing Hispanic population, 60 percent of households defined as 'working poor' or poverty level, with 40 percent uninsured or underinsured.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V - Explanation of Number of Facility Type</FormAndLineReferenceDesc>
        <ExplanationTxt>One Rehabilitation Center and three Home Healthcare services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI - Additional Information</FormAndLineReferenceDesc>
        <ExplanationTxt>Uncompensated care program funds were evenly allocated to uninsured and Medicaid patient costs.</ExplanationTxt>
      </SupplementalInformationDetail>
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          <BusinessNameLine1Txt>American Heart Association</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO Box 50040</AddressLine1Txt>
          <CityNm>Prescott</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>86304</ZIPCd>
        </USAddress>
        <CashGrantAmt>7000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>Donation</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Bethesda Health Clinic</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>409 W Ferguston</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75702</ZIPCd>
        </USAddress>
        <CashGrantAmt>12500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>Donation</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Sonet Service Organization</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2950 50th Street</AddressLine1Txt>
          <CityNm>Lubbock</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>79413</ZIPCd>
        </USAddress>
        <CashGrantAmt>9439509</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>Indigent Care Donation</PurposeOfGrantTxt>
      </RecipientTable>
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      <TotalOtherOrgCnt>3</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Grantmaker's Description of How Grants are Used</FormAndLineReferenceDesc>
        <ExplanationTxt>Senior management will review the needs and give approval to support a variety of agencies, service organziations and projects related to meeting health and human service needs for Tyler and East Texas, as well as those contributing to overall quality of life for the community. Contributions were made in terms of financial and in-kind donations, agencies and organizations supported are non-profit.The ETMC Helping Hands Fund was established to help our fellow employees who may encounter substantial emergency situations and needs. Through generous gifts on the part of ETMC personnel, we are able to help our own by offering immediate, short-term financial assistance to those in need. The Helping Hands Fund is managed through the East Texas Medical Center Foundation and ETMC Human Resources, and governed by an employee review committee.Due to the special nature of the Chaplains Fund, flexibility is essential in its operating procedures. The following guidelines are designed as general policies to be followed by the Chaplains office and the ETMC Foundation.Administration The ETMC Tyler Chaplains Fund is a restricted account under the East Texas Medical Center Foundation. The ETMC Tyler Chaplain supervises the Chaplains Fund on a day-to-day basis. In addition to the Chaplain, the President and Chief Financial Officer of the East Texas Medical Center Regional Healthcare System has signature authorization over the Chaplains Fund account. The Chaplains Fund is included in the financial statements presented at meetings of the ETMC Foundations Board of Directors. The Foundation staff, Board and Executive Committee may help address issues and govern the fund as needed.</ExplanationTxt>
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        <PersonNm>Alireza Behboudi</PersonNm>
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        <PersonNm>Carroll Roge</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Donald E Arego MD</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Doug Johnston DO</PersonNm>
        <TitleTxt>Director</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Eddie Howard</PersonNm>
        <TitleTxt>VP/Administrato</TitleTxt>
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        <TitleTxt>Director</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jack Endres</PersonNm>
        <TitleTxt>Administrator</TitleTxt>
        <BaseCompensationFilingOrgAmt>206206</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>9050</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26226</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>241482</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>James Blanton</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>169056</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1759</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25720</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>196535</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Joseph M Conflitti</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>694752</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>520923</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2860</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12138</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1230673</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Joyce Starling MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>161031</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>2450</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10917</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>174398</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Karen Wies MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>165184</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>369839</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2503</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10844</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>548370</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kenneth Kemp MD</PersonNm>
        <TitleTxt>Former Director (FY 15)</TitleTxt>
        <BaseCompensationFilingOrgAmt>141223</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>47269</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1018</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12138</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>201648</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kim Cooley</PersonNm>
        <TitleTxt>Vice President</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>343335</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>10829</OtherCompensationRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>19727</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>373891</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lawrence Quan MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>176044</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>1235</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1018</OtherCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>178297</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lisa Graves MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>139849</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>335754</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1448</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12138</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>489189</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mark Leitner</PersonNm>
        <TitleTxt>Administrator</TitleTxt>
        <BaseCompensationFilingOrgAmt>210640</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>8219</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>27063</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>245922</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Michael Austin MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>195728</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>219532</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1610</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10917</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>427787</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Michael J Klouda</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>542112</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>171752</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2555</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12138</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>728557</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mike Thomas</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>360584</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>5188</OtherCompensationRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>28644</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>394416</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Nghia Truong MD</PersonNm>
        <TitleTxt>Former Director (FY 12)</TitleTxt>
        <BaseCompensationFilingOrgAmt>419016</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>343733</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1772</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12138</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>776659</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Patrick L Wallace</PersonNm>
        <TitleTxt>Administrator</TitleTxt>
        <BaseCompensationFilingOrgAmt>336176</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>12899</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28323</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>377398</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Paula Anthony</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>365633</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>66112</OtherCompensationRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>26449</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>458194</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Perry Henderson</PersonNm>
        <TitleTxt>Administrator</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>353003</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>2682</OtherCompensationRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>26388</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>382073</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Phil Caron</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>189782</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>9549</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>24140</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>223471</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Robert Evans</PersonNm>
        <TitleTxt>SR VP/Administr</TitleTxt>
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        <OtherCompensationFilingOrgAmt>16120</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26363</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>489681</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Roger Sessions MD</PersonNm>
        <TitleTxt>Former Director (FY 12)</TitleTxt>
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        <BonusFilingOrganizationAmount>22811</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>5159</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12138</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>534227</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Ron Schwartz</PersonNm>
        <TitleTxt>VP EMS</TitleTxt>
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        <OtherCompensationFilingOrgAmt>11393</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28419</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>362291</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Ruth Cook</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Salah Almohammed MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sam Brown</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sam Raborn MD</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Stephen Gale</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Stephen Rydzak MD</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Steven Potter MD</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Terry Cutler</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Todd Parrish MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>374950</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>13043</BonusFilingOrganizationAmount>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Tony Farmer</PersonNm>
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        <TotalCompensationFilingOrgAmt>200943</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WR Christensen MD</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Warren Robicheaux</PersonNm>
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        <TotalCompensationFilingOrgAmt>241606</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>William Roberson D</PersonNm>
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        <OtherCompensationFilingOrgAmt>2644</OtherCompensationFilingOrgAmt>
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        <TotalCompensationFilingOrgAmt>339010</TotalCompensationFilingOrgAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a: Relevant information in regards to selections on 1a.</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule J, Part I, Line 1aCountry club dues are paid for business purpose. Any personal use is reimbursed by the employee.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK.1" softwareId="15000324" softwareVersionNum="2015v3.0">
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        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Camp County Texas</BusinessNameLine1Txt>
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        <PurposeDesc>New hospital facility</PurposeDesc>
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      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
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      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
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      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>D</BondReferenceCd>
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      <TaxExemptBondsProceedsGrp>
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      <TaxExemptBondsProceedsGrp>
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        <PurposeDesc>New Hospital Facility</PurposeDesc>
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        <HedgeTerminatedInd>false</HedgeTerminatedInd>
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        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Express Services Inc</PersonNm>
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        <RelationshipDescriptionTxt>Director</RelationshipDescriptionTxt>
        <TransactionAmt>379175</TransactionAmt>
        <TransactionDesc>Contract Labor Servi</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
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    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="15000324" softwareVersionNum="2015v3.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Client Note 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Client Note 1 - See schedule H for list of subordinate organizations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d: Other Program Services Description</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER PROGRAM SERVICES 4: East Texas Flight Ambulance dba Air One has 3 air ambulances. OTHER PROGRAM SERVICES 5: ETMC Tyler has a Behavioral Health Center that provides inpatient and outpatient mental health services. OTHER PROGRAM SERVICES 6: The ETMC Rehabilitation Hospital has 49 licensed beds. It provides inpatient and outpatient services including physical, occupational and speech therapies, cardiac and pulmonary rehabilitation. ETMC Rehabilitation also offers preventive and health enhancement services. OTHER PROGRAM SERVICES 7: The ETMC Specialty Hospital is a long-term, acute hospital licensed for 36 beds. The hospital is dedicated to acute care for the medically complex patient. Specialized programs include ventilator care, complex multi-system medical, CVA/stroke, trauma, oncology and wound care. OTHER PROGRAM SERVICES 8: ETMC Home Services provides non-hospital health care services. OTHER PROGRAM SERVICES 9: East Texas Medical Center Regional Healthcare System Self Insurance Trust provides self insurance coverage for the East Texas Medical Center Regional Healthcare System entities. OTHER PROGRAM SERVICES 10: ETMC Foundation supports the System and affiliate hospitals as well as the charitable companies affiliated with the System. This includes providing financial assistance to the System, raising, managing and distributing of charitable funds and gifts, providing educational programs on medical and health matters and providing for the regional development of healthcare and medical treatment of illnesses, physical and mental disabilities.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et</FormAndLineReferenceDesc>
        <ExplanationTxt>The following members of ETMC Regional Healthcare System are also board members / key employees of entities affiliated with ETMC Regional Healthcare System: Elmer G. Ellis, Byron Hale, B.G. Hartley, Larry Durrett, Stephen Rydzak, M.D., Freddie Sanchez, David Langston, Carroll Roge and Mike Thomas.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder</FormAndLineReferenceDesc>
        <ExplanationTxt>ETMC Regional Healthcare System is the parent and sole member of the ETMC System affiliates and appoints certain members to the board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>The return is prepared by our staff accountant and is reviewed by senior management. It is then presented to the board for their review and comments. The final return is provided to the board prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization has a written conflict of interest policy for all employees, officers and trustees. Annually all officers, key employees and trustees are required to complete a conflict of interest form disclosing any actual or potential conflict of interest with the organization. Should any transaction arise that may create a conflict, the transaction is reviewed and appropriate measures are taken.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation for the CEO, executive directors and top management is reviewed and approved by independent directors, after considering the results of a compensation survey of comparable positions at comparable entities. The evaluation and determination process, as well as a description of the comparable information utilized, is documented in meeting minutes promptly following the conclusion of the meeting of the directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation for other officers and key employees are reviewed and approved by independent directors, after considering the results of a compensation survey of comparable positions at comparable entities. The evaluation and determination process, as well as a description of the comparable information utilized, is documented in meeting minutes promptly following the conclusion of the meeting of the directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's governing documents, conflict of interest policy and financial statements are provided upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Decreases</FormAndLineReferenceDesc>
        <ExplanationTxt>Cash Mgmt-Dividend to Systems = -$4200000</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Increases</FormAndLineReferenceDesc>
        <ExplanationTxt>Defined Benefit Plan Adjustment = $0</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Decreases</FormAndLineReferenceDesc>
        <ExplanationTxt>Defined Benefit Plan Adjustment = -$5308428</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Increases</FormAndLineReferenceDesc>
        <ExplanationTxt>Eliminate Interco Balance = $7962034</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Increases</FormAndLineReferenceDesc>
        <ExplanationTxt>ETMC Specialty Services Income on Sys books = $0</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Decreases</FormAndLineReferenceDesc>
        <ExplanationTxt>ETMC Specialty Services Income on Sys books = -$201290</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Decreases</FormAndLineReferenceDesc>
        <ExplanationTxt>Interco Cast Transfer to Systems = -$1000000</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Increases</FormAndLineReferenceDesc>
        <ExplanationTxt>Record Affiliates Closing GL Entries = $0</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Decreases</FormAndLineReferenceDesc>
        <ExplanationTxt>Record AffiliatesClosing GL Entries = -$0</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Decreases</FormAndLineReferenceDesc>
        <ExplanationTxt>Rounding = -$1</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Audited Financial Statements</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization was included in consolidated, independent audited financial statements for the tax year.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Fundraising Expenses</FormAndLineReferenceDesc>
        <ExplanationTxt>Fundraising is conducted at the related organization, ETMC Foundation for all ETMC Regional Healthcare System organizations. The expenses are not charged back to the organization.</ExplanationTxt>
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        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Home Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 S Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>752503960</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC Reg Healthcare Sys Self Ins Trust</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 S Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>756345356</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Specialty Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 S Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>752547158</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 S Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>752695524</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Healthcare Associates</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 S Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>752605821</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Athens</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2000 S Palestine</AddressLine1Txt>
          <CityNm>Athens</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75751</ZIPCd>
        </USAddress>
        <EIN>751854562</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Carthage</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>409 Cottage Road</AddressLine1Txt>
          <CityNm>Carthage</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75633</ZIPCd>
        </USAddress>
        <EIN>752735077</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Fairfield</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>125 Newman Street</AddressLine1Txt>
          <CityNm>Fairfield</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75840</ZIPCd>
        </USAddress>
        <EIN>752753454</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Henderson</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>300 Wilson Street</AddressLine1Txt>
          <CityNm>Henderson</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75652</ZIPCd>
        </USAddress>
        <EIN>264123728</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Jacksonville</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>501 South Ragsdale</AddressLine1Txt>
          <CityNm>Jacksonville</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75766</ZIPCd>
        </USAddress>
        <EIN>752715084</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Trinity</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 471</AddressLine1Txt>
          <CityNm>Trinity</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75862</ZIPCd>
        </USAddress>
        <EIN>752715898</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Pittsburg</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>414 Quitman Street</AddressLine1Txt>
          <CityNm>Pittsburg</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75686</ZIPCd>
        </USAddress>
        <EIN>751919624</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC - Quitman</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 1000</AddressLine1Txt>
          <CityNm>Quitman</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75783</ZIPCd>
        </USAddress>
        <EIN>752766160</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC Specialty Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 S Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>460847937</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>East Texas Flight Ambulance dba Air One</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 South Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>473192208</EIN>
        <PrimaryActivitiesTxt>Health Service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ETMC EMS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 South Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>811424190</EIN>
        <PrimaryActivitiesTxt>Health Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Exempt</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ETMC Regional Health Services Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1000 South Beckham Avenue</AddressLine1Txt>
          <CityNm>Tyler</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75701</ZIPCd>
        </USAddress>
        <EIN>751925036</EIN>
        <PrimaryActivitiesTxt>Health Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ETMCRHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>150615123</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>56411293</ShareOfEOYAssetsAmt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ETMC Regional Healthcare SystemETMCRHS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>k</TransactionTypeTxt>
        <InvolvedAmt>15763206</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ETMC Regional Healthcare SystemETMCRHS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>p</TransactionTypeTxt>
        <InvolvedAmt>51158939</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ETMC Regional Healthcare SystemETMCRHS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>q</TransactionTypeTxt>
        <InvolvedAmt>459736</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>