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        <Description>DIETARY SERVICES</Description>
        <BusinessCode>722210</BusinessCode>
        <TotalRevenueColumn>100905</TotalRevenueColumn>
        <ExclusionAmount>100905</ExclusionAmount>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>AMBULENCE TAX APPORTIONMENT</Description>
        <BusinessCode>621910</BusinessCode>
        <TotalRevenueColumn>78826</TotalRevenueColumn>
        <ExclusionAmount>78826</ExclusionAmount>
      </OtherRevenueMisc>
      <MiscellaneousRevenue>
        <TotalRevenueColumn>1565607</TotalRevenueColumn>
        <ExclusionAmount>1565607</ExclusionAmount>
      </MiscellaneousRevenue>
      <TotalOtherRevenue>2013848</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>41554044</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>39051830</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>0</UnrelatedBusinessRevenue>
        <ExclusionAmount>1924557</ExclusionAmount>
      </TotalRevenue>
      <CompCurrentOfficersDirectors>
        <Total>588465</Total>
        <ManagementAndGeneral>588465</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <OtherSalariesAndWages>
        <Total>14775137</Total>
        <ProgramServices>13445375</ProgramServices>
        <ManagementAndGeneral>1329762</ManagementAndGeneral>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>200187</Total>
        <ProgramServices>172161</ProgramServices>
        <ManagementAndGeneral>28026</ManagementAndGeneral>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>2190001</Total>
        <ProgramServices>1883401</ProgramServices>
        <ManagementAndGeneral>306600</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>1012165</Total>
        <ProgramServices>870462</ProgramServices>
        <ManagementAndGeneral>141703</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesLegal>
        <Total>90034</Total>
        <ManagementAndGeneral>90034</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>102789</Total>
        <ManagementAndGeneral>102789</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesOther>
        <Total>2557312</Total>
        <ProgramServices>1993072</ProgramServices>
        <ManagementAndGeneral>564240</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>111175</Total>
        <ProgramServices>80046</ProgramServices>
        <ManagementAndGeneral>31129</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>417325</Total>
        <ProgramServices>291804</ProgramServices>
        <ManagementAndGeneral>125521</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>503243</Total>
        <ProgramServices>377432</ProgramServices>
        <ManagementAndGeneral>125811</ManagementAndGeneral>
      </InformationTechnology>
      <Occupancy>
        <Total>651099</Total>
        <ProgramServices>439026</ProgramServices>
        <ManagementAndGeneral>212073</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>58388</Total>
        <ManagementAndGeneral>58388</ManagementAndGeneral>
      </Travel>
      <Interest>
        <Total>1969897</Total>
        <ProgramServices>1477423</ProgramServices>
        <ManagementAndGeneral>492474</ManagementAndGeneral>
      </Interest>
      <DepreciationDepletion>
        <Total>3606392</Total>
        <ProgramServices>2704794</ProgramServices>
        <ManagementAndGeneral>901598</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>346670</Total>
        <ProgramServices>291584</ProgramServices>
        <ManagementAndGeneral>55086</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>BAD DEBT EXPENSE</Description>
        <Total>4903577</Total>
        <ProgramServices>4903577</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>SUPPLIES</Description>
        <Total>3795737</Total>
        <ProgramServices>3605278</ProgramServices>
        <ManagementAndGeneral>190459</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>COLLECTION FEES</Description>
        <Total>1385666</Total>
        <ManagementAndGeneral>1385666</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>DUES &amp; SUBSCRIPTIONS</Description>
        <Total>107638</Total>
        <ProgramServices>57048</ProgramServices>
        <ManagementAndGeneral>50590</ManagementAndGeneral>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>432202</Total>
        <ProgramServices>407214</ProgramServices>
        <ManagementAndGeneral>24988</ManagementAndGeneral>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>39805099</Total>
        <ProgramServices>32999697</ProgramServices>
        <ManagementAndGeneral>6805402</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>2121929</BOY>
        <EOY>4555663</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>966903</BOY>
        <EOY>819502</EOY>
      </SavingsAndTempCashInvestments>
      <AccountsReceivable>
        <BOY>5060159</BOY>
        <EOY>6486492</EOY>
      </AccountsReceivable>
      <InventoriesForSaleOrUse>
        <BOY>857536</BOY>
        <EOY>932973</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>486743</BOY>
        <EOY>409301</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>45710836</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>16602796</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>31904478</BOY>
        <EOY>29108040</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
        <BOY>3508082</BOY>
        <EOY>3606739</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsProgramRelated>
        <BOY>451648</BOY>
        <EOY>442722</EOY>
      </InvestmentsProgramRelated>
      <OtherAssetsTotal>
        <BOY>1220911</BOY>
        <EOY>520168</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>46578389</BOY>
        <EOY>46881600</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>2871236</BOY>
        <EOY>2972027</EOY>
      </AccountsPayableAccruedExpenses>
      <TaxExemptBondLiabilities>
        <BOY>33997989</BOY>
        <EOY>32407931</EOY>
      </TaxExemptBondLiabilities>
      <OtherLiabilities>
        <BOY>1458979</BOY>
        <EOY>1502628</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>38328204</BOY>
        <EOY>36882586</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>8106832</BOY>
        <EOY>9855777</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>143353</BOY>
        <EOY>143237</EOY>
      </TemporarilyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>8250185</BOY>
        <EOY>9999014</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>46578389</BOY>
        <EOY>46881600</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>1748945</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>-116</ReconcilationOtherChanges>
      <InfoInScheduleOPartXII>X</InfoInScheduleOPartXII>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>0</AccountantCompileOrReview>
      <FSAudited>1</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      </FSAuditedBasis>
      <AuditCommittee>1</AuditCommittee>
      <FederalGrantAuditRequired>0</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <Volunteers>0</Volunteers>
      <PaidStaffOrManagement>0</PaidStaffOrManagement>
      <MediaAdvertisements>0</MediaAdvertisements>
      <MailingsMembers>0</MailingsMembers>
      <PublicationsOrBroadcast>0</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>0</GrantsOtherOrganizations>
      <DirectContactLegislators>0</DirectContactLegislators>
      <RalliesDemonstrations>0</RalliesDemonstrations>
      <OtherActivities>1</OtherActivities>
      <OtherActivitiesAmount>8731</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>8731</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>0</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>EXPLANATION OF LOBBYING ACTIVITIES:</Identifier>
        <ReturnReference>PART II-B, LINE 1:</ReturnReference>
        <Explanation>LOBBYING EXPENSES THROUGH DUES PAID TO KHA (KANSAS HOSPITAL ASSOCIATION) AND AHA (AMERICAN HOSPITAL ASSOCIATION).</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <Land>
        <OtherCostOrOtherBasis>979525</OtherCostOrOtherBasis>
        <BookValue>979525</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>15028103</OtherCostOrOtherBasis>
        <Depreciation>8386490</Depreciation>
        <BookValue>6641613</BookValue>
      </Buildings>
      <Equipment>
        <OtherCostOrOtherBasis>27068990</OtherCostOrOtherBasis>
        <Depreciation>7567556</Depreciation>
        <BookValue>19501434</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>2634218</OtherCostOrOtherBasis>
        <Depreciation>648750</Depreciation>
        <BookValue>1985468</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>29108040</TotalOfBookValueLandBuildings>
      <OtherLiabilities>
        <Description>DUE TO AFFILIATE</Description>
        <Amount>655283</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DEFERRED COMPENSATION</Description>
        <Amount>483740</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>OTHER CURRENT LIABILITIES</Description>
        <Amount>363605</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>1502628</TotalOfAmounts>
      <FootnoteInPartXIII>X</FootnoteInPartXIII>
      <TotRevenueEtcAuditedFinclStmt>41595877</TotRevenueEtcAuditedFinclStmt>
      <OtherRevenues>41833</OtherRevenues>
      <RevenueNotRptdF990>41833</RevenueNotRptdF990>
      <RevenueSubtotal>41554044</RevenueSubtotal>
      <RevenueNotRptdOnFinStmt>0</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>41554044</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>39846932</TotExpensesEtcAuditedFinclStmt>
      <OtherExpensesIncluded>41833</OtherExpensesIncluded>
      <ExpensesNotRptdF990>41833</ExpensesNotRptdF990>
      <ExpensesSubtotal>39805099</ExpensesSubtotal>
      <ExpensesNotRptdOnFinStmt>0</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>39805099</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIII>
        <Identifier>DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:</Identifier>
        <ReturnReference>PART X, LINE 2:</ReturnReference>
        <Explanation>THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL AND FOUNDATION EACH FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THIS RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HOSPITALS AND FOUNDATIONS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY, THE CONTINUED TAX EXEMPT STATUS OF BONDS ISSUED BY THE OBLIGATED GROUP, THE NATURE, THE CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). UBI IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF SEPTEMBER 30, 2013 AND 2012, THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY. FORMS 990 AND 990T FILED BY THE HOSPITAL AND FOUNDATION ARE GENERALLY SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN.</Explanation>
      </Form990ScheduleDPartXIII>
      <Form990ScheduleDPartXIII>
        <Identifier>PART XI, LINE 2D - OTHER ADJUSTMENTS:</Identifier>
        <Explanation>RENTAL EXPENSES 41,833.</Explanation>
      </Form990ScheduleDPartXIII>
      <Form990ScheduleDPartXIII>
        <Identifier>PART XII, LINE 2D - OTHER ADJUSTMENTS:</Identifier>
        <Explanation>RENTAL EXPENSES 41,833.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <CharityCarePolicy>1</CharityCarePolicy>
      <WrittenPolicy>1</WrittenPolicy>
      <FPGReferenceFreeCare>1</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>1</FPGReferenceDiscountedCare>
      <Pcent300>X</Pcent300>
      <FreeDiscCareMedicallyIndigent>1</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>1</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>0</ExpensesExceededBudget>
      <AnnualCommunityBenefitReport>1</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>1</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>192596</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>192596</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00550</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>4437491</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>3738509</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>698982</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02000</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>4630087</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>3738509</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>891578</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02550</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>135433</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>4050</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>131383</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00380</PercentOfTotalExpense>
      </CommunityHealthServices>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>1813151</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>1813151</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05200</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>1948584</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>4050</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1944534</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05580</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>6578671</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>3742559</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2836112</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.08130</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>1</BadDebtExpenseReported>
      <BadDebtExpenseAmount>1804481</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>7336200</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>6767973</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>568227</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>1</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>1</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>ATCHISON HOSPITAL ASSOCIATION</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>800 RAVEN HILL DRIVE</AddressLine1>
          <City>ATCHISON</City>
          <State>KS</State>
          <ZIPCode>66002</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>ATCHISON HOSPITAL ASSOCIATION</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <CHNAConducted>1</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <NeedsAssessmentConducted>12</NeedsAssessmentConducted>
        <TakeIntoAccount>1</TakeIntoAccount>
        <OtherFacilities>0</OtherFacilities>
        <CHNAWidelyAvailable>1</CHNAWidelyAvailable>
        <OwnWebsite>X</OwnWebsite>
        <OnRequest>X</OnRequest>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>1</AllNeedsAddressed>
        <OrganizationIncurExciseTax>0</OrganizationIncurExciseTax>
        <EligibilityCriteriaExplained>1</EligibilityCriteriaExplained>
        <UsesFPGFree>1</UsesFPGFree>
        <FPGFreePercent>200.000000000000</FPGFreePercent>
        <UsesFPGDiscounted>1</UsesFPGDiscounted>
        <FPGDiscountPercent>200.000000000000</FPGDiscountPercent>
        <ExplainsBasis>1</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <InsuranceStatus>X</InsuranceStatus>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <StateRegulation>X</StateRegulation>
        <ExplainsApplicationMethod>1</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>1</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>1</ActionsOnNonpayment>
        <CollectionActivities>0</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>1</NondiscrimEmergencyCarePolicy>
        <MedicareRate>X</MedicareRate>
        <AmountsGenerallyBilled>0</AmountsGenerallyBilled>
        <GrossCharges>0</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>2</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FAMILY MEDICAL CENTER OF TROY</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>311 W LOCUST</AddressLine1>
            <City>TROY</City>
            <State>KS</State>
            <ZIPCode>66087</ZIPCode>
          </Address>
          <FacilityType>RURAL HEALTH CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FAMILY MEDICAL CENTER OF EFFINGHAM</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>512 MAIN STREET</AddressLine1>
            <City>EFFINGHAM</City>
            <State>KS</State>
            <ZIPCode>66023</ZIPCode>
          </Address>
          <FacilityType>RURAL HEALTH CLINIC</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, LINE 3C: NOT APPLICABLE</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OR SCHEDULE H, IS A COST TO CHARGE RATIO CALCULATED USING WORKSHEET 2.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, LINE 7G: NO COSTS ASSOCIATED WITH A PHYSICIAN CLINIC WERE REPORTED IN SUBSIDIZED HEALTH SERVICES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4903577.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE COSTING METHOD FOR DETERMINING THE AMOUNT ON LINE 2 IS THE ACTUAL BAD DEBT EXPENSE MULTIPLIED BY THE COST TO CHARGE RATIO FOR THE OVERALL HOSPITAL. THE MAJORITY OF THE BAD DEBT COMES FROM PATIENTS WHO HAVE VISITED THE EMERGENCY DEPARTMENT AND HAVE BEEN TREATED REGARDLESS OF THEIR ABILITY TO PAY BASED ON EMTALA GUIDELINES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 8: ANY MEDICARE SHORTFALL SHOULD NOT BE TREATED AS A COMMUNITY BENEFIT COST. THE COSTING METHODOLOGY CONSISTED OF INFORMATION FOR THE HOSPITAL'S ACCOUNTING SYSTEM AS WELL AS COSTS FROM THE MEDICARE COST REPORT.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 9B: THE HOSPITAL DOES NOT PURSUE COLLECTION ON ACCOUNTS THAT IT HAS BEEN DETERMINED THE PATIENT IS ELIGIBLE FOR CHARITY CARE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>PART V, SECTION B, LINE 3:</ReturnReference>
        <Explanation>A SURVEY WAS MAILED OUT TO A REPRESENTATIVE SAMPLE OF THE COMMUNITY AND A COMMUNITY TOWN HALL WAS ADVERTISED IN THE LOCAL PAPER AND LOCAL RADIO STATION FOR THE COMMUNITY TO ATTEND. THE SURVEY RESULTS WERE DISCUSSED AT THE TOWN HALL MEETING.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 2: ATCHISON HOSPITAL ASSOCIATION HAS ACCESS TO THE KANSAS HEALTH INITIATIVE SURVEY ON HEALTH INDICATORS. BASED ON THESE INDICATORS, ATCHISON HOSPITAL DETERMINES THE NEEDS OF THE COMMUNITY AND WHAT PROGRAMS TO IMPLEMENT.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 3: PATIENTS ARE GIVEN A PAMPHLET DESCRIBING THE POLICY FOR FINANCIAL ASSISTANCE WHEN THEY ARE ADMITTED. THE ADMITTING OFFICE ASKS THEM TO SPEAK WITH THE HOSPITAL FINANCIAL COUNSELOR IF THEY DO NOT HAVE INSURANCE. AFTER THE PATIENT RECEIVES THEIR STATEMENT IN THE MAIL, THEY CAN CALL IN AND TALK WITH THE FINANCIAL COUNSELOR. IF THE ACCOUNT GOES TO A COLLECTION COMPANY BECAUSE THE PATIENT DID NOT PAY OR TALK WITH THE FINANCIAL COUNSELOR, THE COLLECTION COMPANY WILL GIVE THEM THE PROPER APPLICATION TO FILL OUT TO SEE IF THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>PART VI, LINE 4:</ReturnReference>
        <Explanation>THE HOSPITAL SERVES THE COMMUNITY OF ATCHISON, KS AND THE SURROUNDING COUNTY OF ATCHISON, KS. ATCHISON IS A COMMUNITY OF APPROXIMATELY 10,500 PEOPLE WHO WOULD BE DESCRIBED AS MOSTLY COMPRISED OF BLUE COLLAR AND LOW INCOME INDIVIDUALS. THE SURROUNDING COUNTY HAS A POPULATION OF AN ADDITIONAL 6,300 PEOPLE. THERE ARE SEVERAL LARGE FARMS WHICH PLANT ROW CROPS OF CORN AND BEANS.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <ClubDuesOrFees>X</ClubDuesOrFees>
      <WrittenPolicyReTAndEExpenses>1</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>1</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>0</SeverancePayment>
      <SupplementalNonqualRetirePlan>0</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>0</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>0</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>0</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>0</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>0</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>1</AnyNonFixedPayments>
      <InitialContractException>0</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>JOHN L JACOBSON</NamePerson>
        <Title>DIRECTOR/CEO</Title>
        <BaseCompensationFilingOrg>175578</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>10000</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>1109</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>2683</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>20947</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>210317</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>BENJAMIN STONE</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>275109</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>220</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>1800</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>20947</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>298076</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>STEPHEN MEIROSE</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>251812</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>249</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>1327</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>24248</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>277636</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MICHAEL JONES</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>158204</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>39743</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>45402</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>3583</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>7487</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>254419</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>RYAN THOMAS</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>228161</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>77342</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>13269</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>3938</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>24648</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>347358</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>EVERETT WILKINSON</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>248168</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>121</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>8771</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>257060</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <ReturnReference>PART I, LINE 1A</ReturnReference>
        <Explanation>SOCIAL CLUB DUES WERE PAID BY THE HOSPITAL FOR JOHN L. JACOBSON AND WERE NOT INCLUDED IN HIS W-2 AS TAXABLE COMPENSATION BECAUSE THEY WERE USED 100% FOR BUSINESS.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <ReturnReference>PART I, LINE 7</ReturnReference>
        <Explanation>VARIOUS EMPLOYED PHYSICIANS ARE PROVIDED THE OPPORTUNITY FOR BONUS POTENTIAL, IN THEIR CONTRACT WITH THE HOSPITAL ARE TIERS BASED ON CURRENT MEDICAL GROUP MANAGEMENT ASSOCIATION REGIONAL DATA. IF THE PHYSICIANS ANNUALIZED NET QUALIFIED PATIENT CHARGES EXCEEDS THE TIER, A PERCENTAGE OF THEIR NET QUALIFIED PATIENT CHARGES ARE ELIGIBLE FOR BONUS SUBJECT TO THEIR ANNUAL BASE COMPENSATION.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <Form990ScheduleKPartI>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>CITY OF ATCHISON</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>486025033</IssuerEIN>
        <CUSIPNumber>046687AW9</CUSIPNumber>
        <DateIssued>2008-09-23</DateIssued>
        <IssuePrice>10000000</IssuePrice>
        <DescriptionOfPurpose>REPLACEMENT OF FACILITIES</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>CITY OF ATCHISON</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>486025033</IssuerEIN>
        <CUSIPNumber>046687AW9</CUSIPNumber>
        <DateIssued>2008-09-23</DateIssued>
        <IssuePrice>7500000</IssuePrice>
        <DescriptionOfPurpose>REDEMPTION OF SERIES 2007 BOND</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>CITY OF ATCHISON</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>486025033</IssuerEIN>
        <CUSIPNumber>046687CA5</CUSIPNumber>
        <DateIssued>2009-06-30</DateIssued>
        <IssuePrice>17620000</IssuePrice>
        <DescriptionOfPurpose>REPLACEMENT OF FACILITIES</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceeds>10000000</TotalProceeds>
        <IssuanceCostsFromProceeds>206983</IssuanceCostsFromProceeds>
        <CapitalExpenditures>9793017</CapitalExpenditures>
        <YearOfSubstCompletion>2008</YearOfSubstCompletion>
        <CurrentRefunding>0</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceeds>7500000</TotalProceeds>
        <IssuanceCostsFromProceeds>156373</IssuanceCostsFromProceeds>
        <CapitalExpenditures>7343627</CapitalExpenditures>
        <YearOfSubstCompletion>2008</YearOfSubstCompletion>
        <CurrentRefunding>1</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <BondReferenceCd>C</BondReferenceCd>
        <TotalProceeds>17620000</TotalProceeds>
        <IssuanceCostsFromProceeds>396323</IssuanceCostsFromProceeds>
        <CapitalExpenditures>17223677</CapitalExpenditures>
        <YearOfSubstCompletion>2009</YearOfSubstCompletion>
        <CurrentRefunding>0</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedProperty>0</OwningBondFinancedProperty>
        <AnyLeaseArrangements>0</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>0</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>0</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <BondIssMeetPrvtSecurityPayTest>0</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>0</ChangeInUseBondFinancedProp>
        <NonQualifiedBondRemedProcdrs>0</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedProperty>0</OwningBondFinancedProperty>
        <AnyLeaseArrangements>0</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>0</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>0</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <BondIssMeetPrvtSecurityPayTest>0</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>0</ChangeInUseBondFinancedProp>
        <NonQualifiedBondRemedProcdrs>0</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedProperty>0</OwningBondFinancedProperty>
        <AnyLeaseArrangements>0</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>0</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>0</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <BondIssMeetPrvtSecurityPayTest>0</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>0</ChangeInUseBondFinancedProp>
        <NonQualifiedBondRemedProcdrs>0</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiled>0</Form8038TFiled>
        <RebateNotDueYet>0</RebateNotDueYet>
        <ExceptionToRebate>0</ExceptionToRebate>
        <NoRebateDue>1</NoRebateDue>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>0</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>0</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiled>0</Form8038TFiled>
        <RebateNotDueYet>0</RebateNotDueYet>
        <ExceptionToRebate>0</ExceptionToRebate>
        <NoRebateDue>1</NoRebateDue>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>0</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>0</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiled>0</Form8038TFiled>
        <RebateNotDueYet>0</RebateNotDueYet>
        <ExceptionToRebate>0</ExceptionToRebate>
        <NoRebateDue>1</NoRebateDue>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>0</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>0</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>A</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>0</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>B</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>0</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>C</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>0</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartVI>
        <Identifier>SCHEDULE K PART IV, ARBITRAGE, LINE 2C</Identifier>
        <ReturnReference>DATE REBATE COMPUTATION PERFORMED</ReturnReference>
        <Explanation>ISSUER NAME: CITY OF ATCHISON DATE THE REBATE COMPUTATION WAS PERFORMED: 09/01/2012 ISSUER NAME: CITY OF ATCHISON DATE THE REBATE COMPUTATION WAS PERFORMED: 09/01/2012 ISSUER NAME: CITY OF ATCHISON DATE THE REBATE COMPUTATION WAS PERFORMED: 06/01/2013</Explanation>
      </Form990ScheduleKPartVI>
      <Form990ScheduleKPartVI>
        <Identifier>SCHEDULE K, PART V</Identifier>
        <ReturnReference>PROCEDURES TO UNDERTAKE CORRECTIVE ACTION</ReturnReference>
        <Explanation>THE ORGANIZATION IS IN THE PROCESS OF WRITING PROCEDURES TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION IS NOT AVAILABLE UNDER APPLICABLE REGULATIONS. THESE PROCEDURES WILL BE IN PLACE BY THE END OF THE CURRENT FISCAL YEAR - SEPTEMBER 30, 2014.</Explanation>
      </Form990ScheduleKPartVI>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 11</ReturnReference>
        <Explanation>AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S MANAGEMENT. ANY QUESTIONS OR CONCERNS THE ORGANIZATION'S MANAGEMENT HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE 990 IS THEN REVIEWED BY THE HOSPITAL FINANCE COMMITTEE. ANY QUESTIONS OR CONCERNS THE FINANCE COMMITTEE HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE 990 IS THEN REVIEWED BY THE BOARD OF DIRECTORS, ANY CORRECTIONS OR CONCERNS THE BOARD HAVE ARE ADDRESSED PRIOR TO FILING.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>AT THE TIME OF ELECTION OR HIRE AND ANNUALLY THEREAFTER, THE GOVERNING BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES SHALL PROVIDE THE APPLICABLE CONFLICT OF INTEREST DISCLOSURES WHICH SHALL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES IN WHICH IT IS BELIEVED A CONFLICT MAY ARISE. IF A CONFLICT ARISES, THE BOARD MEMBER ABSTAINS FROM THE VOTE OF THE CONFLICTED POSITION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15</ReturnReference>
        <Explanation>IN 2011, THE ORGANIZATION ENGAGED ITS LEGAL COUNSEL TO PREPARE A COMPENSATION DATA STUDY. IN ADDITION TO VARIOUS DATA COLLECTED, OTHER HOSPITALS' 990'S WERE REVIEWED AND COMBINED IN THE COMPENSATION STUDY. THE HOSPITAL'S LEGAL COUNSEL REVIEWED THE STUDY WITH THE BOARD OF DIRECTORS TO ADJUST THE CEO'S COMPENSATION. ANY DECISION THAT IS MADE IN REGARDS TO THE CEO'S COMPENSATION IS DOCUMENTED BY THE BOARD OF DIRECTORS. THE CEO AND HUMAN RESOURCE DIRECTOR CONDUCT AN ANNUAL REVIEW OF OTHER OFFICERS AND KEY EMPLOYEES' COMPENSATION BASED ON COMPARABLE DATA OF OTHER ORGANIZATIONS OF SIMILAR SIZE AND INDUSTRY. PHYSICIAN COMPENSATION IS DETERMINED BASED ON CONTRACT AND IS COMPARED TO RECENT MEDICAL GROUP MANAGEMENT ASSOCIATION INFORMATION BY REGION TO DETERMINE FAIR MARKET COMPENSATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>THE ORGANIZATION GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES:</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 9:</ReturnReference>
        <Explanation>ASSETS RELEASED FROM RESTRICTION -116.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART XII, LINE 2C</ReturnReference>
        <Explanation>AN INDEPENDENT ACCOUNTING FIRM AUDITS THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION HAS A COMMITEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED DURING THE TAX YEAR.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>RIVERBEND REGIONAL HEALTHCARE FOUNDATION</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>800 RAVEN HILL DRIVE</AddressLine1>
          <City>ATCHISON</City>
          <State>KS</State>
          <ZIPCode>66002</ZIPCode>
        </AddressUS>
        <EIN>480955489</EIN>
        <PrimaryActivities>SUPPORT</PrimaryActivities>
        <LegalDomicileState>KS</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>LINE 11B, II</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ATCHISON HOSPITAL ASSOCIATION</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>1</ControlledOrg>
      </Form990ScheduleRPartII>
      <ReceiptOfIntAnnRentsRoyalties>0</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>0</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>1</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>0</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>0</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>0</DividendsRelatedOrganization>
      <SaleOfAssetsToOtherOrg>0</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>0</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>0</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>0</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>0</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>0</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>0</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>1</SharingOfFacilities>
      <SharingOfPaidEmployees>1</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>0</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>0</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>0</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>0</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>RIVERBEND REGIONAL HEALTHCARE FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>C</TransactionType>
        <AmountInvolved>430000</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>