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        <Identifier>ELECTION OF MEMBERS AND THEIR RIGHTS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 7A</ReturnReference>
        <Explanation>MEMBERS ARE ELECTED AS A RESULT OF FINDING OTHER PUBLICLY SUPPORTED HOSPITALS OR PUBLIC ENTITIES DOMICILED IN THE STATE OF TEXAS WHO DESIRE TO AFFILIATE WITH EACH OTHER IN ORDER TO IMPROVE HEALTH CARE DELIVERY IN THEIR RESPECTIVE COMMUNITIES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DECISIONS SUBJECT TO APPROVAL OF MEMBERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 7B</ReturnReference>
        <Explanation>THE GOVERNING BODY CONSITS ENTIRELY OF DIRECTORS/MEMBERS AND AS SUCH ALL DECISIONS OF THE GOVERNING BODY ARE THEREBY CONTEMPORANEOUSLY APPROVED BY THE MEMBERS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ORGANIZATION'S PROCESS USED TO REVIEW FORM 990</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 11B</ReturnReference>
        <Explanation>THE GOVERNING BODY REVIEWS THE FORM 990 AT THE MEETING FOLLOWING THE COMPLETION OF THE RETURN.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ENFORCEMENT OF CONFLICTS POLICY</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 12C</ReturnReference>
        <Explanation>THE ORGANIZATION REQUIRES EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER TO ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B) HAS READ AND UNDERSTANDS THE POLICY, C) HAS AGREED TO COMPLY WITH THE POLICY, AND D) UNDERSTANDS THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION, THE ORGANIZATION CONDUCTS PERIODIC REVIEWS OF ITS CONFLICT OF INTEREST PROCEDURES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>GOVERNING DOCUMENTS DISCLOSURE EXPLANATION</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 19</ReturnReference>
        <Explanation>THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES</Identifier>
        <ReturnReference>FORM 990, PART IX, LINE 11G</ReturnReference>
        <Explanation>PHARMACY SERVICES 162,786 0 0 PHYSICIAN SUPPORT SERVICES 7,191,203 0 0 DIAGNOSTIC SERVICES 239,148 0 0 PHYSICAL THERAPY SERVICES 314,014 0 0 ANESTHESIA SERVICES 1,037,938 0 0 EMS SERVICES 16,500 0 0</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>