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      <TotalReportableCompFrmRltdOrgs>500652</TotalReportableCompFrmRltdOrgs>
      <TotalOtherCompensation>116111</TotalOtherCompensation>
      <NumberIndividualsGT100K>7</NumberIndividualsGT100K>
      <FormersListed>false</FormersListed>
      <TotalCompGT150K>true</TotalCompGT150K>
      <CompensationFromOtherSources>false</CompensationFromOtherSources>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>LEONARD S FIORE</NamePerson>
        </NameOfContractor>
        <AddressOfContractor />
        <DescriptionOfServices>BUILDING CONTRACTOR</DescriptionOfServices>
        <Compensation>7154289</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>HEALTHCARE SERVICES GROUP</NamePerson>
        </NameOfContractor>
        <AddressOfContractor />
        <DescriptionOfServices>HOUSEKEEPING SERVICE</DescriptionOfServices>
        <Compensation>1459418</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>SODEXHO</NamePerson>
        </NameOfContractor>
        <AddressOfContractor />
        <DescriptionOfServices>NUTRITION SERVICES</DescriptionOfServices>
        <Compensation>1401983</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>ASSOCIATED CLINICAL LABORATORIES</NamePerson>
        </NameOfContractor>
        <AddressOfContractor />
        <DescriptionOfServices>LAB SERVICES</DescriptionOfServices>
        <Compensation>697202</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>VANTAGE CARE APOTHECARY</NamePerson>
        </NameOfContractor>
        <AddressOfContractor />
        <DescriptionOfServices>PHARMACY SVCS AT PCM</DescriptionOfServices>
        <Compensation>410890</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>16</NumberOfContractorsGT100K>
      <RelatedOrganizations>43230</RelatedOrganizations>
      <GovernmentGrants>2291245</GovernmentGrants>
      <AllOtherContributions>595770</AllOtherContributions>
      <TotalContributions>2930245</TotalContributions>
      <ProgramServiceRevenue>
        <Description>NET PATIENT SERVICE REVENUE</Description>
        <BusinessCode>621990</BusinessCode>
        <TotalRevenueColumn>74880098</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>74880098</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>CAFETERIA INCOME</Description>
        <BusinessCode>722210</BusinessCode>
        <TotalRevenueColumn>409282</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>409282</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>EHR INCENTIVE</Description>
        <BusinessCode>621990</BusinessCode>
        <TotalRevenueColumn>1963070</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>1963070</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>OTHER SERVICE REVENUE</Description>
        <BusinessCode>621990</BusinessCode>
        <TotalRevenueColumn>1103187</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>1103187</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalProgramServiceRevenue>78355637</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>254062</TotalRevenueColumn>
        <ExclusionAmount>254062</ExclusionAmount>
      </InvestmentIncome>
      <IncomeFromInvestBondProceeds>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </IncomeFromInvestBondProceeds>
      <RoyaltiesRevenue>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </RoyaltiesRevenue>
      <GrossRents>
        <Real>531802</Real>
      </GrossRents>
      <LessRentalExpenses>
        <Real>470588</Real>
      </LessRentalExpenses>
      <RentalIncomeOrLoss>
        <Real>61214</Real>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>61214</TotalRevenueColumn>
        <ExclusionAmount>61214</ExclusionAmount>
      </NetRentalIncomeOrLoss>
      <GrossAmountSalesAssets>
        <Securities>1872706</Securities>
        <Other>22118</Other>
      </GrossAmountSalesAssets>
      <LessCostOthBasisSalesExpenses>
        <Securities>1886042</Securities>
      </LessCostOthBasisSalesExpenses>
      <GainOrLoss>
        <Securities>-13336</Securities>
        <Other>22118</Other>
      </GainOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>8782</TotalRevenueColumn>
        <ExclusionAmount>8782</ExclusionAmount>
      </NetGainOrLossInvestments>
      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromGaming>
      <NetIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeOrLoss>
      <OtherRevenueMisc>
        <Description>MOB HOUSEKEEPING</Description>
        <BusinessCode>812900</BusinessCode>
        <TotalRevenueColumn>49804</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>49804</UnrelatedBusinessRevenue>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>PHYSICIAN BILLING</Description>
        <BusinessCode>519100</BusinessCode>
        <TotalRevenueColumn>130233</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>130233</UnrelatedBusinessRevenue>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>LOSS ON INVESTMENT IN EQUITY INVESTEE</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>-1017270</TotalRevenueColumn>
        <ExclusionAmount>-1017270</ExclusionAmount>
      </OtherRevenueMisc>
      <TotalOtherRevenue>-837233</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>80772707</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>78355637</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>180037</UnrelatedBusinessRevenue>
        <ExclusionAmount>-693212</ExclusionAmount>
      </TotalRevenue>
      <GrantsToDomesticOrgs>
        <Total>2000</Total>
        <ProgramServices>2000</ProgramServices>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>468966</Total>
        <ManagementAndGeneral>468966</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>68827</Total>
        <ManagementAndGeneral>68827</ManagementAndGeneral>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>34788204</Total>
        <ProgramServices>31180091</ProgramServices>
        <ManagementAndGeneral>3604880</ManagementAndGeneral>
        <Fundraising>3233</Fundraising>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>1088233</Total>
        <ProgramServices>979744</ProgramServices>
        <ManagementAndGeneral>108489</ManagementAndGeneral>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>5337537</Total>
        <ProgramServices>4781866</ProgramServices>
        <ManagementAndGeneral>555671</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>2241442</Total>
        <ProgramServices>1996399</ProgramServices>
        <ManagementAndGeneral>245043</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>177839</Total>
        <ManagementAndGeneral>177839</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>146334</Total>
        <ManagementAndGeneral>146334</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>30917</Total>
        <ManagementAndGeneral>30917</ManagementAndGeneral>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>6416704</Total>
        <ProgramServices>5616031</ProgramServices>
        <ManagementAndGeneral>800673</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>224698</Total>
        <ManagementAndGeneral>224698</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>8375514</Total>
        <ProgramServices>7411591</ProgramServices>
        <ManagementAndGeneral>963923</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>388022</Total>
        <ManagementAndGeneral>388022</ManagementAndGeneral>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>1128962</Total>
        <ProgramServices>981961</ProgramServices>
        <ManagementAndGeneral>147001</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>83214</Total>
        <ProgramServices>75930</ProgramServices>
        <ManagementAndGeneral>7284</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>178821</Total>
        <ProgramServices>162279</ProgramServices>
        <ManagementAndGeneral>16542</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>813057</Total>
        <ProgramServices>712361</ProgramServices>
        <ManagementAndGeneral>100696</ManagementAndGeneral>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>2939107</Total>
        <ProgramServices>2575103</ProgramServices>
        <ManagementAndGeneral>364004</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>1051176</Total>
        <ProgramServices>432540</ProgramServices>
        <ManagementAndGeneral>618636</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>BAD DEBT</Description>
        <Total>4592035</Total>
        <ProgramServices>4592035</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>MEDICAL SUPPLIES &amp; DRUGS</Description>
        <Total>4939269</Total>
        <ProgramServices>4939269</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>LICENSES, DUES, SUBSCRIPTIONS</Description>
        <Total>206958</Total>
        <ProgramServices>55408</ProgramServices>
        <ManagementAndGeneral>151550</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>RECRUITING &amp; RETENTION</Description>
        <Total>329200</Total>
        <ProgramServices>18288</ProgramServices>
        <ManagementAndGeneral>310912</ManagementAndGeneral>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>28807</Total>
        <ManagementAndGeneral>28807</ManagementAndGeneral>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>76045843</Total>
        <ProgramServices>66512896</ProgramServices>
        <ManagementAndGeneral>9529714</ManagementAndGeneral>
        <Fundraising>3233</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>60663</BOY>
        <EOY>5615</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>5724710</BOY>
        <EOY>6142822</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
        <BOY>1702600</BOY>
        <EOY>1156944</EOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
        <BOY>8147847</BOY>
        <EOY>7312930</EOY>
      </AccountsReceivable>
      <ReceivablesFromOfficersEtc>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </ReceivablesFromOfficersEtc>
      <ReceivablesFromDisqualPersons>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </ReceivablesFromDisqualPersons>
      <OtherNotesLoansReceivableNet>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </OtherNotesLoansReceivableNet>
      <InventoriesForSaleOrUse>
        <BOY>547906</BOY>
        <EOY>546189</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>404695</BOY>
        <EOY>416433</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>91720020</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>58102448</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>26309551</BOY>
        <EOY>33617572</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
        <BOY>4684308</BOY>
        <EOY>4620814</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsOtherSecurities>
        <BOY>6383507</BOY>
        <EOY>4901163</EOY>
      </InvestmentsOtherSecurities>
      <InvestmentsProgramRelated>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </InvestmentsProgramRelated>
      <IntangibleAssets>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </IntangibleAssets>
      <OtherAssetsTotal>
        <BOY>26472394</BOY>
        <EOY>3979726</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>80438181</BOY>
        <EOY>62700208</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>8278445</BOY>
        <EOY>9133126</EOY>
      </AccountsPayableAccruedExpenses>
      <GrantsPayable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </GrantsPayable>
      <DeferredRevenue>
        <BOY>2245952</BOY>
        <EOY>0</EOY>
      </DeferredRevenue>
      <TaxExemptBondLiabilities>
        <BOY>7868772</BOY>
        <EOY>7307893</EOY>
      </TaxExemptBondLiabilities>
      <EscrowAccountLiability>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </EscrowAccountLiability>
      <LoansFromOfficersDirectors>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </LoansFromOfficersDirectors>
      <MortNotesPyblSecuredInvestProp>
        <BOY>15199574</BOY>
        <EOY>19837442</EOY>
      </MortNotesPyblSecuredInvestProp>
      <UnsecuredNotesLoansPayable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </UnsecuredNotesLoansPayable>
      <OtherLiabilities>
        <BOY>7418444</BOY>
        <EOY>11235169</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>41011187</BOY>
        <EOY>47513630</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>36958459</BOY>
        <EOY>14029632</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>2468535</BOY>
        <EOY>1156946</EOY>
      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>39426994</BOY>
        <EOY>15186578</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>80438181</BOY>
        <EOY>62700208</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>4726864</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>-28967280</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>true</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>true</FederalGrantAuditPerformed>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <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="IRS990ScheduleC">
      <TotalGrassrootsLobbying />
      <TotalDirectLobbying />
      <TotalLobbyingExpenditures />
      <OtherExemptPurposeExpenditures />
      <TotalExemptPurposeExpenditures />
      <LobbyingNontaxableAmount />
      <GrassrootsNontaxableAmount />
      <TotLobbyingGrassrootMinusNonTx />
      <TotLobbyExpendMnsLobbyingNontx />
      <Volunteers>false</Volunteers>
      <PaidStaffOrManagement>false</PaidStaffOrManagement>
      <MediaAdvertisements>false</MediaAdvertisements>
      <MailingsMembers>false</MailingsMembers>
      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>false</GrantsOtherOrganizations>
      <DirectContactLegislators>false</DirectContactLegislators>
      <RalliesDemonstrations>false</RalliesDemonstrations>
      <OtherActivities>true</OtherActivities>
      <OtherActivitiesAmount>7508</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>7508</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>false</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>LOBBYING ACTIVITIES</Identifier>
        <ReturnReference>SCHEDULE C, PART II-B, LINE 1I</ReturnReference>
        <Explanation>THE ORGANIZATION IS A MEMBER OF SEVERAL ORGANIZATIONS OF WHICH A PORTION OF THE DUES ARE ATTRIBUTABLE TO LOBBYING. THE ORGANIZATION IS A MEMBER OF THE HOSPITAL &amp; HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA (HAP), TO WHICH IT PAYS $7,897 IN GENERAL MEMBERSHIP DUES. OF THAT AMOUNT, 25.04% MAY BE ATTRIBUTABLE TO LOBBYING, OR $1,977. THE ORGANIZATION ALSO PAYS $16,386 OF AHA MEMBERSHIP DUES TO HAP, OF WHICH 24.6% MAY BE ATTRIBUTABLE TO LOBBYING, OR $4,031. THE ORGANIZATION IS ALSO A MEMBER OF THE HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA, OF WHICH 15% OF ITS $10,000 DUES ARE ATTRIBUTABLE TO LOBBYING, OR $1,500. TOTAL DUES ATTRIBUTABLE TO LOBBYING ARE $7,508.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <CurrentYearMinus3Years />
      <Land>
        <InvestmentCostOrOtherBasis>215000</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>144166</OtherCostOrOtherBasis>
        <BookValue>359166</BookValue>
      </Land>
      <Buildings>
        <InvestmentCostOrOtherBasis>1785000</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>45765702</OtherCostOrOtherBasis>
        <Depreciation>28376692</Depreciation>
        <BookValue>19174010</BookValue>
      </Buildings>
      <LeaseholdImprovements />
      <Equipment>
        <OtherCostOrOtherBasis>32847611</OtherCostOrOtherBasis>
        <Depreciation>28062289</Depreciation>
        <BookValue>4785322</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <InvestmentCostOrOtherBasis>10882</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>10951659</OtherCostOrOtherBasis>
        <Depreciation>1663467</Depreciation>
        <BookValue>9299074</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>33617572</TotalOfBookValueLandBuildings>
      <FinancialDerivatives />
      <CloselyHeldEquityInterests />
      <OtherSecurities>
        <Description>CLOSELY-HELD EQUITY INTERESTS</Description>
        <BookValue>4901163</BookValue>
      </OtherSecurities>
      <TotalOfBookValueSecurities>4901163</TotalOfBookValueSecurities>
      <OtherAssets>
        <Description>DUE FROM AFFILIATES</Description>
        <BookValue>1774545</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>OTHER RECEIVABLES</Description>
        <BookValue>751332</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>ACCRUED INTEREST</Description>
        <BookValue>30728</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>CHART RECEIVABLE</Description>
        <BookValue>1423121</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>3979726</TotalBookValueOtherAssets>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>ACCRUED PENSION LIABILITY</Description>
        <Amount>10568317</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO THIRD PARTY PAYERS</Description>
        <Amount>666852</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>11235169</TotalOfAmounts>
      <TotalRevenue>80772707</TotalRevenue>
      <TotalExpenses>76045843</TotalExpenses>
      <ExcessOrDeficitForYear>4726864</ExcessOrDeficitForYear>
      <NetUnrealizedGLOnInvestments>-42162</NetUnrealizedGLOnInvestments>
      <OtherAmount>-30749548</OtherAmount>
      <TotalAdjustments>-30791710</TotalAdjustments>
      <ExcessOrDeficitPerFS>-26064846</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>50212443</TotRevenueEtcAuditedFinclStmt>
      <NetUnrealizedGainsInvestments>-42162</NetUnrealizedGainsInvestments>
      <OtherRevenues>-30742309</OtherRevenues>
      <RevenueNotRptdF990>-30784471</RevenueNotRptdF990>
      <RevenueSubtotal>80996914</RevenueSubtotal>
      <OtherRevenuesNotIncluded>-224207</OtherRevenuesNotIncluded>
      <RevenueNotRptdOnFinStmt>-224207</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>80772707</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>76277289</TotExpensesEtcAuditedFinclStmt>
      <OtherExpensesIncluded>231446</OtherExpensesIncluded>
      <ExpensesNotRptdF990>231446</ExpensesNotRptdF990>
      <ExpensesSubtotal>76045843</ExpensesSubtotal>
      <TotalExpensesPerForm990>76045843</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIV>
        <Identifier>UNCERTAIN TAX POSITIONS</Identifier>
        <ReturnReference>SCHEDULE D, PART X, LINE 2</ReturnReference>
        <Explanation>MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>OTHER CHANGE IN NET ASSETS</Identifier>
        <ReturnReference>SCHEDULE D, PART XI, LINE 8</ReturnReference>
        <Explanation>OTHER RECONCILING CHANGE IN NET ASSETS $ (6,628,536) CHANGE IN DEFINED BENEFIT PLAN (22,296,582) TRANSFER TO AFFILIATES (1,824,430) CHANGE IN REM NET ASSETS ---------- $ (30,749,548) TOTAL CHANGE IN NET ASSETS</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12</Identifier>
        <ReturnReference>SCHEDULE D, PART XII, LINE 2D</ReturnReference>
        <Explanation>$(6,628,536) CHANGE IN DEFINED BENEFIT PLAN (22,296,582) TRANSFER TO AFFILIATES (1,817,191) REM TRANSFER FROM AFFILIATE ------------ $(30,742,309) TOTAL</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1</Identifier>
        <ReturnReference>SCHEDULE D, PART XII, LINE 4B</ReturnReference>
        <Explanation>$(231,446) ERHC RENTAL EXPENSES (239,142) REM RENTAL EXPENSES 246,381 REM RENTAL INCOME ---------- $(224,207) TOTAL</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>OTHER EXPENSES INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25</Identifier>
        <ReturnReference>SCHEDULE D, PART XIII, LINE 2D</ReturnReference>
        <Explanation>$ 231,446 ERHC RENTAL EXPENSES</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent100>X</Pcent100>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent300>X</Pcent300>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>false</AmountsBudgetedForCharityCare>
      <AnnualCommunityBenefitReport>false</AnnualCommunityBenefitReport>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>90203</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>90203</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00130</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>9403638</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>9374562</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>29077</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00040</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>9493841</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>9374562</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>119280</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00170</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>161755</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>35861</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>125894</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00180</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>14883</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>10758</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>4125</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>1969770</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1474565</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>495205</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00690</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>2717</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>2717</NetCommunityBenefitExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>2149125</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1521184</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>627941</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00880</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>11642966</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>10895746</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>747221</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01050</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <EconomicDevelopment>
        <TotalCommunityBuildingExpense>2740</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>2740</NetCommunityBuildingExpense>
      </EconomicDevelopment>
      <CoalitionBuilding>
        <TotalCommunityBuildingExpense>1176</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>1176</NetCommunityBuildingExpense>
      </CoalitionBuilding>
      <WorkforceDevelopment>
        <TotalCommunityBuildingExpense>147077</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>50815</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>9262</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00130</PercentOfTotalExpense>
      </WorkforceDevelopment>
      <Total>
        <TotalCommunityBuildingExpense>150993</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>50815</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>13178</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00130</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseAmount>4592035</BadDebtExpenseAmount>
      <AmountAttributableTo>505124</AmountAttributableTo>
      <AmountReimbursedByMedicare>20571048</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>25274272</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-4703224</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed />
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>false</ProvisionForCharityCare>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>RASC LLC</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>SURGERY CENTER</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.61500</OrganizationProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.17667</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>ELK REGIONAL HEALTH CENTER</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>763 JOHNSONBURG ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <Er24Hours>X</Er24Hours>
        <Other>SKILLED NURSING PHYSICIAN OFFICES</Other>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>ELK REGIONAL HEALTH CENTER</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>100</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>300.</FPGDiscountPercent>
        <ExplainsBasis>false</ExplainsBasis>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>false</IncludesPublicityMeasures>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NotifyBeforeDischarge>X</NotifyBeforeDischarge>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>5</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>ERHC RIDGWAY CAMPUS</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>304 METOXET STREET</AddressLine1>
            <City>RIDGWAY</City>
            <State>PA</State>
            <ZIPCode>15853</ZIPCode>
          </Address>
          <FacilityType>MEDICAL EXPRESS PHYSICIAN OFFICES PHYSICAL THERAPY</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>DR STOKES</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>275 E FOURTH STREET</AddressLine1>
            <City>EMPORIUM</City>
            <State>PA</State>
            <ZIPCode>15834</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN OFFICES</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>DR CARUSO</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>174 SKYLINE DRIVE</AddressLine1>
            <City>KERSEY</City>
            <State>PA</State>
            <ZIPCode>15846</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN OFFICES</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>DR MCKIMM</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>416 N BROAD ST</AddressLine1>
            <City>EMPORIUM</City>
            <State>PA</State>
            <ZIPCode>15834</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN OFFICES</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>DR SORG</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1095 MILLION DOLLAR HIGHWAY</AddressLine1>
            <City>ST MARYS</City>
            <State>PA</State>
            <ZIPCode>15857</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN OFFICES</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Identifier>PERCENT OF TOTAL EXPENSE</Identifier>
        <ReturnReference>SCHEDULE H, PART I, LINE 7</ReturnReference>
        <Explanation>TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COST TO CHARGE RATIO</Identifier>
        <ReturnReference>SCHEDULE H, PART I, LINE 7</ReturnReference>
        <Explanation>THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 AND 3. ACTUAL COST BASED ON THE ORGANIZATION'S COST REPORT WAS USED ON IRS WORKSHEET 6.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>BAD DEBT EXPENSE</Identifier>
        <ReturnReference>SCHEDULE H, PART III, LINE 4</ReturnReference>
        <Explanation>THE HEALTH SYSTEM PROVIDES FOR AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, WHICH IS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. ACCOUNTS ARE CONSIDERED DELIQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE ORGANIZATION CALCULATED BAD DEBT BY USING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS PER THE AUDITED FINANCIAL STATEMENTS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY BENEFIT</Identifier>
        <ReturnReference>SCHEDULE H, PART III, SECTION B, LINE 8</ReturnReference>
        <Explanation>SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COLLECTION POLICY</Identifier>
        <ReturnReference>SCHEDULE H, PART III, SECTION C, LINE 9B</ReturnReference>
        <Explanation>THOSE INDIVIDUALS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, SUBSEQUENT TO THEIR ACCOUNT BALANCE BEING ADJUSTED ACCORDINGLY, ACTUALLY ARE TREATED IN THE SAME MANNER AS ALL OTHER INDIVIDUALS WITH SELF-PAY BALANCES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>REVISION OF POLICIES</Identifier>
        <ReturnReference>SCHEDULE H, PART V, SECTION B, LINES 11 &amp; 13</ReturnReference>
        <Explanation>THE FINANCIAL ASSISTANCE POLICY IN PLACE AS OF 6/30/12 DID NOT INCLUDE AN EXPLANATION OF THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS OR MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED. THE ORGANIZATION IS IN THE PROCESS OF REVISING THE POLICIES TO REFLECT THESE ITEMS. MAXIMUM AMOUNTS CHARGED SCHEDULE H, PART V, SECTION B, LINE 19D AS OF 6/30/12, 25% OF BLUE CROSS OR MC FEE SCHEDULES ARE USED TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS. THE POLICY IS IN THE PROCESS OF BEING REVISED AND THIS MAY BE CHANGED TO REFLECT ONE OF THE OTHER CHOICES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>NEEDS ASSESSMENT</Identifier>
        <Explanation>THE ORGANIZATION IS IN THE PROCESS OF COMPLETING A FORMAL NEEDS ASSESSMENT.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</Identifier>
        <Explanation>THE CHARITY CARE POLICY, IN ITS ENTIRETY, APPEARS ON THE HOSPITAL WEBSITE. THE ASSOCIATED ELIGIBILITY FORM IS OBTAINABLE HERE AS WELL. THE SELF-PAY COLLECTION PROCESS PROVIDES FOR A CHARITY CARE APPLICATION AND EXPLANATION LETTER TO BE SENT ON EVERY OUTSTANDING PATIENT ACCOUNT FOR WHICH THERE IS NOT A PAYMENT MADE SUBSEQUENT TO THE INITIAL STATEMENT BEING RECEIVED. THERE ARE ALSO SIGNS POSTED IN CERTAIN AREAS OF THE HEALTH CENTER WHICH PROMOTE THE EXISTENCE OF THE CHARITY CARE POLICY AND DIRECT INTERESTED INDIVIDUALS ACCORDINGLY.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY INFORMATION</Identifier>
        <Explanation>THE ORGANIZATION PROVIDES SERVICES TO RESIDENTS OF ALL AGES IN ELK AND CAMERON COUNTIES AND THE SURROUNDING AREAS. ELK AND CAMERON COUNTIES HAVE A POPULATION OF APPROXIMATELY 37,000. ADULTS OVER AGE 65 REPRESENT ABOUT 20% OF THE POPULATION. PERSONS BELOW POVERTY LEVEL ACCOUNT FOR ABOUT 11% OF THE POPULATION. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $43,000, AND THE MEDIAN VALUE OF OWNER-OCCUPIED HOUSING UNITS IS APPROXIMATELY $89,000. ELK REGIONAL IS ONE OF TWO MAJOR HEALTH SYSTEMS THAT SERVE THE ELK AND CAMERON COUNTY COMMUNITIES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY BUILDING ACTIVITIES</Identifier>
        <Explanation>ERHC STRIVES TO PROVIDE WELLNESS AND EDUCATIONAL PROGRAMS FOR COMMUNITY MEMBERS TO MAINTAIN A HEALTHY LIFESTYLE. ERHC PROVIDES SMOKE DETECTORS TO PARENTS OF NEWBORNS TO TAKE HOME WITH THEM &amp; INSTALL IN THEIR HOMES. ERHC WORKS WITH THE LOCAL LIONS CLUB &amp; ROTARY CLUB TO PROVIDE SERVICES TO THE COMMUNITY. ERHC PARTICIPATES IN ACTIVITIES WITH THE ST. MARYS CHAMBER OF COMMERCE AND BELONGS TO THE BOARDS OF THE FAMILY RESOURCE NETWORK AND THE STATE HEALTH IMPROVEMENT PLAN. ERHC PROVIDES JOB SHADOWING TO THE LOCAL HIGH SCHOOL STUDENTS AND HAS A SCHOOL TO WORK PROGRAM FOR STUDENTS. ERHC ALSO PARTICIPATES IN THE PHEAA PROGRAM TO HIRE STUDENTS AS SUMMER WORKERS TO GIVE THEM WORK EXPERIENCE IN VARIOUS FIELDS. OTHER INFORMATION: THE ORGANIZATION HAS AN OPEN MEDICAL STAFF AND THE BOARD IS COMPRISED OF PEOPLE WHO ARE LEADERS IN THE COMMUNITY. THE PHYSICIAN OFFICES &amp; OUTPATIENT THERAPY OFFICES LOCATED THROUGHOUT THE COMMUNITIES GIVE PATIENTS EASIER ACCESS TO VARIOUS SERVICES. ERHC PARTICIPATES IN AND HOLDS HEALTH FAIRS WHERE FREE SCREENINGS &amp; LOW OR NO COSTS TESTING ARE PROVIDED TO PROMOTE PREVENTATIVE CARE AND HEALTH LIFESTYLES. ERHC HOLDS MANY EDUCATIONAL CLASSES FOR THE PUBLIC SUCH AS DIABETES EDUCATION, WOMEN'S HEALTH ISSUES, SUPPORT GROUPS, ETC. ERHC ALSO OFFERS VARIOUS EXERCISE CLASSES SUCH AS PILATES, BOOT CAMP, YOGA, ETC., ALONG WITH WELLNESS CLASSES. THE ORGANIZATION PERIODICALLY HAS PRESS RELEASES ON DIFFERENCE HEALTH ISSUES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>OTHER INFORMATION</Identifier>
        <Explanation>THE ORGANIZATION HAS AN OPEN MEDICAL STAFF AND THE BOARD IS COMPRISED OF PEOPLE WHO ARE LEADERS IN THE COMMUNITY. THE PHYSICIAN OFFICES &amp; OUTPATIENT THERAPY OFFICES LOCATED THROUGHOUT THE COMMUNITIES GIVE PATIENTS EASIER ACCESS TO VARIOUS SERVICES. ERHC PARTICIPATES IN AND HOLDS HEALTH FAIRS WHERE FREE SCREENINGS &amp; LOW OR NO COSTS TESTING ARE PROVIDED TO PROMOTE PREVENTATIVE CARE AND HEALTH LIFESTYLES. ERHC HOLDS MANY EDUCATIONAL CLASSES FOR THE PUBLIC SUCH AS DIABETES EDUCATION, WOMEN'S HEALTH ISSUES, SUPPORT GROUPS, ETC. ERHC ALSO OFFERS VARIOUS EXERCISE CLASSES SUCH AS PILATES, BOOT CAMP, YOGA, ETC., ALONG WITH WELLNESS CLASSES. THE ORGANIZATION PERIODICALLY HAS PRESS RELEASES ON DIFFERENCE HEALTH ISSUES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>AFFILIATED HEALTH CARE SYSTEM ROLES</Identifier>
        <Explanation>ELK REGIONAL HEALTH CENTER IS A FULLY-ACCREDITED, NOT-FOR-PROFIT 80-BED GENERAL ACUTE CARE INSTITUTION BACKED BY THE EXPERTISE OF A DEDICATED, EMPLOYED PHYSICIAN GROUP AND THE STRENGTH OF A CLINICAL RELATIONSHIP WITH UPMC HAMOT IN ERIE, PA. WITH CAMPUSES IN ST. MARYS AND RIDGWAY AND PHYSICIAN OFFICES IN A NUMBER OF LOCATIONS THROUGHOUT THE REGION, ELK REGIONAL PROUDLY SERVES THE RESIDENTS OF ELK AND CAMERON COUNTIES. IT IS THE ONGOING MISSION OF THE ELK REGIONAL HEALTH SYSTEM TO PROVIDE PREMIER HEALTHCARE SERVICES TO PATIENTS THROUGH COMMITMENTS TO SERVICE, QUALITY, PEOPLE, FINANCE AND GROWTH - ALL WHILE MAINTAINING ECONOMIC VIABILITY AND KEEPING AN EYE ON THE FUTURE. THE HOSPITAL AND PHYSICIAN OFFICES WORK WITH COMMUNITY NURSES INC., TO PROVIDE FLU SHOT CLINICS TO THE COMMUNITY. THE FOUNDATION AND AUXILIARY PROVIDE EDUCATIONAL CLASSES AND SCHOLARSHIPS. THERE ARE MANY SCREENINGS &amp; HEALTH CLINICS HELD THROUGHOUT THE YEAR TO PROMOTE HEALTHY LIVING &amp; PREVENTATIVE CARE. ERHC ALSO OFFERS EXERCISE, NUTRITION, AND RELAXATION CLASSES. THE HEALTH SYSTEM FOUNDATION OFFERS 2 SCHOLARSHIPS EACH YEAR TO STUDENTS PURSUING HEALTH CARE FIELDS. COMMUNITY NURSES INC ESTABLISHED A SERENITY GARDEN FOR PINE CREST MANOR (SKILLED NURSING FACILITY) RESIDENTS AND FAMILY AND FOR THE GENERAL PUBLIC TO USE AS A MEDIATION GARDEN. CNI ALSO PROVIDES ADULT DAY CARE SERVICES FOR THE COMMUNITY. THE HOSPITAL AUXILIARY GIVES A SCHOLARSHIP TO A TEEN VOLUNTEER FROM EACH LOCAL SCHOOL WHO ARE GOING TO STUDY A HEALTH CARE RELATED FIELD. THE PHYSICIAN OFFICES AND COMMUNITY NURSES WORK TOGETHER TO PUT ON VARIOUS FLU CLINICS TO PROVIDE ANNUAL FLU SHOTS TO MEMBERS OF THE COMMUNITY. ERHC PROVIDES A SMOKING CESSATION PROGRAM TO THE PUBLIC FOR THOSE WHO ARE TRYING TO QUIT SMOKING. ERHC HAS A CRNP THAT GOES INTO THE LOCAL SCHOOLS EACH YEAR TO EDUCATE STUDENTS ABOUT GOOD HYGIENE AND HEALTH ISSUES ASSOCIATED WITH ADOLESCENCE. THE ORGANIZATION ALSO PROVIDES FREE SPORTS PHYSICALS FOR THE LOCAL YOUTH FOOTBALL TEAM.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
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      <IndependentConsultant>X</IndependentConsultant>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>true</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
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        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>16360</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>3345</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>12073</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>155868</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>SEVERANCE PAYMENTS</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 4A</ReturnReference>
        <Explanation>LARRY ZIMMEL RECEIVED SEVERANCE PAYMENTS TOTALING $14,995.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 4B</ReturnReference>
        <Explanation>457(F) PLAN EMPLOYEE CONTRIBUTIONS GREG BAUER $4,483</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>ELLEN SCUTELLA</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V.</Relationship>
        <AmountOfTransaction>37372</AmountOfTransaction>
        <DescriptionOfTransaction>SEE PART V.</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>NICKLAS INSURANCE AGENCY</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V.</Relationship>
        <AmountOfTransaction>201961</AmountOfTransaction>
        <DescriptionOfTransaction>SEE PART V.</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>KAREN GASPARI</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V.</Relationship>
        <AmountOfTransaction>31455</AmountOfTransaction>
        <DescriptionOfTransaction>SEE PART V.</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>NORTHWEST SAVINGS BANK</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V.</Relationship>
        <AmountOfTransaction>301349</AmountOfTransaction>
        <DescriptionOfTransaction>SEE PART V.</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Identifier>BUSINESS TRANSACTIONS</Identifier>
        <ReturnReference>SCHEDULE L, PART IV</ReturnReference>
        <Explanation>(1) ELLEN SCUTELLA IS THE WIFE OF FRANK SCUTELLA, CHAIRMAN ELECT. SHE IS EMPLOYED BY ELK REGIONAL HEALTH CENTER WITH REPORTABLE COMPENSATION OF $36,061 AND RELATED BENEFITS OF $1,311. TOTAL COMPENSATION RECEIVED WAS $37,372. (2) FRANK SCUTELLA IS AN OWNER OF NICKLAS INSURANCE AGENCY. THE ORGANIZATION RECEIVES PROPERTY, BOILER, AND BUSINESS AUTO INSURANCE FROM THE AGENCY, WITH TOTAL PAYMENTS EQUAL TO $201,961 FOR THE YEAR. (3) KAREN GASPARI IS THE SISTER OF LAURIE MACDONALD, ERHC CFO/VP OF FINANCE. SHE IS EMPLOYED BY ERHC AND RECEIVED REPORTABLE COMPENSATION OF $30,244 AND RELATED BENEFITS OF $1,211. TOTAL COMPENSATION RECEIVED WAS $31,455. (4) NEIL HOFFMAN, DIRECTOR, IS THE CORPORATE SENIOR VP OF NORTHWEST SAVINGS BANK, TO WHICH THE ORGANIZATION PAID $301,349 IN INTEREST EXPENSE DURING THE YEAR.</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>PROGRAM SERVICE ACCOMPLISHMENTS</Identifier>
        <ReturnReference>FORM 990, PART III, LINE 4D</ReturnReference>
        <Explanation>THE HEALTH CENTER IS A SOLE COMMUNITY HOSPITAL PROVIDING PRIMARY ACUTE CARE MEDICAL SERVICES TO TWO CAMPUSES, THE ST. MARYS HEALTH CENTER IN ST. MARYS, PENNSYLVANIA, AND THE RIDGWAY HEALTH CENTER IN RIDGWAY, PENNSYLVANIA. OTHER PROGRAM SERVICES INCLUDE MEALS ON WHEELS, COMMUNITY NURSING, HEALTHY BEGINNINGS, AND SPORTS MEDICINE AND OTHER HEALTHCARE RELATED ACTIVITIES. ADDITIONALLY, THE HEALTH CENTER RECEIVED EHR INCENTIVE PAYMENTS THROUGH THE MEANINGFUL USE PROGRAM.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>MEMBERS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINES 6, 7A, &amp; 7B</ReturnReference>
        <Explanation>THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ELK REGIONAL HEALTH SYSTEM (ERHS), A RELATED PENNSYLVANIA NON-PROFIT CORPORATION. ERHS AND ERHC HAVE A COMMON BOARD OF DIRECTORS. ALL POWERS OF ERHC ARE EXERCISED BY THE BOARD OF DIRECTORS PROVIDED THAT THE BOARD OBTAINS THE APPROVAL OF THE HEALTH SYSTEM BEFORE ACTION ON ANY MATTERS BECOMES FINAL AND EFFECTIVE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990 REVIEW PROCESS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 11B</ReturnReference>
        <Explanation>THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE DRAFT FORM 990 IS REVIEWED BY THE CFO AND THE CONTROLLER. AFTER ALL SUGGESTED CHANGES FROM THE CFO AND CONTROLLER ARE MADE, THE UPDATED DRAFT FORM 990 IS PRESENTED AT THE FINANCE COMMITTEE MEETING. AFTER ANY FINAL CHANGES ARE MADE, A COPY IS PROVIDED TO THE FULL BOARD BEFORE FILING.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CONFLICT OF INTEREST POLICY COMPLIANCE</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>THE WRITTEN CONFLICT OF INTEREST POLICY IS GIVEN TO BOARD MEMBERS ANNUALLY ALONG WITH A LETTER AND DISCLOSURE STATEMENT. THE CHAIRMAN OF THE BOARD REVIEWS THESE DISCLOSURE STATEMENTS AND SUBMITS A REPORT TO THE EXECUTIVE COMMITTEE CONCERNING ANY CONFLICTS OF INTEREST. THE BOARD MEMBERS ALSO COMPLETE A SEPARATE QUESTIONNAIRE DEVELOPED TO HELP ANSWER THE NEW FORM 990 QUESTIONS. ANY INDIVIDUAL HAVING A CONFLICT OF INTEREST WITH RESPECT TO ANY MATTER WILL NEITHER VOTE NOR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. THIS INDIVIDUAL WILL ALSO NOT BE COUNTED IN DETERMINING THE QUORUM FOR ANY ACTION ON THE MATTER IN QUESTION. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE OF THE INTEREST, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION DETERMINATION</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINES 15A &amp; 15B</ReturnReference>
        <Explanation>THE CEO'S CONTRACT IS REVIEWED ANNUALLY BY THE BOARD. AS PART OF THIS PROCESS, THE BOARD USES AN OUTSIDE CONSULTING FIRM AND SALARY SURVEYS AS COMPARABILITY DATA. NO OTHER OFFICERS RECEIVE THIS SALARY REVIEW. THE PROCESS IS DISCUSSED WITH THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND DOCUMENTED IN THE MINUTES. THE CHAIRMAN OF THE BOARD SIGNS THE CONTRACT APPROVING ANY CHANGES AS AGREED UPON. IN 2011, A COMPENSATION COMMITTEE WAS STARTED AND AN EXECUTIVE COMPENSATION PHILOSOPHY WAS DEVELOPED.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>GOVERNING DOCUMENT AVAILABILITY</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST FROM LORI SCUTELLA, ADMINISTRATIVE SECRETARY. DOCUMENTS MAY BE MAILED, E-MAILED, FAXED, OR HELD FOR PICKUP BY REQUESTING PERSONS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>BOARD MEMBER COMPENSATION &amp; RELATED ORGANIZATION HOURS</Identifier>
        <ReturnReference>FORM 990, PART VII, SECTION A</ReturnReference>
        <Explanation>NO DIRECTORS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. DR. DAVID JOHE IS PAID AS A PHYSICIAN IN ERPG AND IS PRESIDENT OF MEDICAL STAFF. HE WORKS APPROXIMATELY 40 HOURS PER WEEK FOR THE RELATED ORGANIZATION. GREG BAUER, ERHC PRESIDENT/CEO, AND LAURIE MACDONALD, CFO/VP OF FINANCE, WORK APPROXIMATELY 40 HOURS PER WEEK BETWEEN ERHC, ELK REGIONAL HEALTH SYSTEM, ERHS FOUNDATION, ELK REGIONAL PROFESSIONAL GROUP, AND ERHS AUXILIARY. THESE ORGANIZATIONS ALSO SHARE A COMMON BOARD.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5</ReturnReference>
        <Explanation>CHANGE IN DEFINED BENEFIT PLAN $(6,628,536) TRANSFERS TO AFFILIATES (22,296,582) UNREALIZED LOSS ON INVESTMENT (42,162) ---------- TOTAL OTHER CHANGES $(28,967,280)</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>ELK REGIONAL SURGERY CENTER REAL ESTATE</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1376 BUCKTAIL ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>272160971</EIN>
        <PrimaryActivities>REAL EST MGMT</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <TotalIncome>7239</TotalIncome>
        <EOYAssets>1780223</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartI>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>ELK REGIONAL HEALTH SYSTEM FOUNDATION</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>763 JOHNSONBURG ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251636685</EIN>
        <PrimaryActivities>SUPPORT</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11A I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ERHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>ELCO HOUSING</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>759 JOHNSONBURG ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251639115</EIN>
        <PrimaryActivities>HOUSING</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ERHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>ELK REGIONAL PROFESSIONAL GROUP INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>763 JOHNSONBURG ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251875183</EIN>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ERHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>ELK REGIONAL HEALTH SYSTEM AUXILIARY</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>763 JOHNSONBURG ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251429093</EIN>
        <PrimaryActivities>SUPPORT</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ERHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>ELK REGIONAL HEALTH SYSTEM</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>763 JOHNSONBURG ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251636723</EIN>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>COMMUNITY NURSES HOME HEALTH &amp; HOSPICE</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>757 JOHNSONBURG ROAD STE 200</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>250996070</EIN>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>CNI</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>COMMUNITY NURSES HOME SUPPORT SERVICES</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>757 JOHNSONBURG ROAD STE 200</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251623601</EIN>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>CNI</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>COMMUNITY NURSES INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>757 JOHNSONBURG ROAD STE 200</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251623598</EIN>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ERHS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>ELK REG MRI CTR</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>763 JOHNSONBURG ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251924737</EIN>
        <PrimaryActivity>MRI CENTER</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>RELATED</PredominantIncomeType>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>593031</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
        <PercentageOwnership>0.99000</PercentageOwnership>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>REG AMBUL SURG CTR</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1376 BUCKTAIL ROAD</AddressLine1>
          <City>ST MARYS</City>
          <State>PA</State>
          <ZIPCode>15857</ZIPCode>
        </AddressUS>
        <EIN>251873083</EIN>
        <PrimaryActivity>SURGERY CENTER</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>RELATED</PredominantIncomeType>
        <ShareOfTotalIncome>211787</ShareOfTotalIncome>
        <ShareOfEOYAssets>2322635</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
        <PercentageOwnership>0.62501</PercentageOwnership>
      </Form990ScheduleRPartIII>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>true</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>true</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>